# SUMMIT MEDICAL GROUP ARIZONA LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053810622
- **Authorized official:** DALTON DUNN (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (623) 271-2094

## Contact information

- **Practice address:** 5620 W THUNDERBIRD RD STE F1, GLENDALE, AZ 85306-4652
- **Practice address phone:** (844) 969-0686
- **Practice address fax:** (773) 832-7083
- **Mailing address:** PO BOX 24981, BELFAST, ME 04915-2000
- **Mailing address phone:** (615) 672-7122
- **Mailing address fax:** (615) 672-7849

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | — | NULL | — |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2084N0400X | Neurology Physician | — | NULL | — |
| 2084N0400X | Neurology Physician | — | — | — |
| 213E00000X | Podiatrist | — | NULL | — |
| 213E00000X | Podiatrist | — | — | — |

## Other

- **Enumeration date:** 02/08/2018
- **Last updated:** 10/01/2026