Organization
SUMMIT MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUDITH A LINDSEY MD (PHYSICIAN AND SURGEON)
(503) 307-1422
Entity
Organization
Contact information
Practice address
12633 SE OATFIELD RD, MILWAUKIE, OR 97222-6939
(503) 307-1422
Mailing address
PO BOX 22165, MILWAUKIE, OR 97269-2165
(503) 307-1422
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
17146
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235344060
MEDICARE NPI
OR
01
—
1922074160
MEDICARE NPI
OR
01
—
1932162880
MEDICARE NPI
OR
05
—
287403
—
OR
01
—
715535-81
OREGON STATE BUSINESS LIC
OR
Enumeration date
05/14/2007
Last updated
10/19/2012
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