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Organization
SUMMIT SURGICAL SUITES, LLC
Active
Organization
SUMMIT SURGICAL SUITES, LLC
Active
Other names
Southwest Surgical Suites
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY MUSIC (DIRECTOR OF PROVIDER ENROLLMENT-AO)
(615) 465-7377
Entity
Organization
Contact information
Practice address
7920 W JEFFERSON BLVD, SUITE 210, FORT WAYNE, IN 46804-4168
(260) 434-2022
(260) 434-2023
Mailing address
7920 W JEFFERSON BLVD, SUITE 210, FORT WAYNE, IN 46804-4168
(260) 434-2022
(260) 434-2023
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
05-003212-1
IN
Other
Enumeration date
08/09/2005
Last updated
08/12/2024
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