# SUMMIT HEALTHCARE MEDICAL ASSOCIATES

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

## Provider details

- **NPI number:** 1093368789
- **Authorized official:** MR. KENNETH ROBERT ALLEN (ADMINISTRATOR)
- **Authorized official phone:** (928) 537-4375

## Contact information

- **Practice address:** 728 E WHITE MOUNTAIN BLVD, PINETOP, AZ 85929
- **Practice address phone:** (952) 653-2565
- **Practice address fax:** (952) 653-2540
- **Mailing address:** 728 E WHITE MOUNTAIN BLVD, PINETOP, AZ 85929
- **Mailing address phone:** (952) 653-2565
- **Mailing address fax:** (952) 653-2540

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/22/2019
- **Last updated:** 07/22/2019