# SUMMIT SKIN CARE INCORPORATED

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Summit Skin and Vein Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902099500
- **Authorized official:** BRUCE E FEARON MD (OWNER / PRESIDENT)
- **Authorized official phone:** (816) 554-7546

## Contact information

- **Practice address:** 3521 NE RALPH POWELL RD STE C, LEES SUMMIT, MO 64064-2324
- **Practice address phone:** (816) 554-8346
- **Practice address fax:** (816) 554-9470
- **Mailing address:** 3521 NE RALPH POWELL RD STE C, LEES SUMMIT, MO 64064-2324
- **Mailing address phone:** (816) 554-8346
- **Mailing address fax:** (816) 554-9470

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 102868 | MO | Yes |

## Other

- **Enumeration date:** 08/27/2007
- **Last updated:** 09/16/2022