# SUMMIT EXPRESS URGENT CARE, LLC

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

## Provider details

- **NPI number:** 1528489259
- **Authorized official:** DR. L NICOL PETTWAY M.D. (OWNER)
- **Authorized official phone:** (205) 329-4565

## Contact information

- **Practice address:** 1360 MONTGOMERY HWY, SUITE 124, VESTAVIA, AL 35216-2749
- **Practice address phone:** (205) 329-4565
- **Mailing address:** 4322 KINGS MOUNTAIN RDG, VESTAVIA, AL 35242-2242

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 19390 | AL | Yes |

## Other

- **Enumeration date:** 12/23/2013
- **Last updated:** 12/23/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1376588095 | NPI | AL |