# SUMMIT PODIATRY GROUP PC

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

## Provider details

- **NPI number:** 1295825099
- **Authorized official:** DR. KRISTI J LEDBETTER DPM (VICE PRESIDENT)
- **Authorized official phone:** (517) 784-0900

## Contact information

- **Practice address:** 2797 SPRING ARBOR ROAD, SUITE A, JACKSON, MI 49203
- **Practice address phone:** (517) 784-0900
- **Practice address fax:** (517) 784-7835
- **Mailing address:** 2797 SPRING ARBOR ROAD, SUITE A, JACKSON, MI 49203
- **Mailing address phone:** (517) 784-0900
- **Mailing address fax:** (517) 784-7835

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 10/13/2006
- **Last updated:** 10/21/2020