# SUMMIT PEDIATRICS, LLC

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

## Provider details

- **NPI number:** 1700151818
- **Authorized official:** DR. TAMARA L PETERSON D.O. (GENERAL PEDIATRICIAN/MANAGER)
- **Authorized official phone:** (816) 525-2800

## Contact information

- **Practice address:** 3171 NE CARNEGIE DR, SUITE A, LEES SUMMIT, MO 64064-3215
- **Practice address phone:** (816) 525-2800
- **Practice address fax:** (816) 525-4077
- **Mailing address:** 3171 NE CARNEGIE DR, SUITE A, LEES SUMMIT, MO 64064-3215
- **Mailing address phone:** (816) 525-2800
- **Mailing address fax:** (816) 525-4077

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 2008015364 | MO | Yes |

## Other

- **Enumeration date:** 03/21/2012
- **Last updated:** 04/26/2016