Organization
SUMMIT PODIATRY GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTI J LEDBETTER DPM (VICE PRESIDENT)
(517) 784-0900
Entity
Organization
Contact information
Practice address
2797 SPRING ARBOR ROAD, SUITE A, JACKSON, MI 49203
(517) 784-0900
(517) 784-7835
Mailing address
2797 SPRING ARBOR ROAD, SUITE A, JACKSON, MI 49203
(517) 784-0900
(517) 784-7835
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0380060001
MEDICARE NSC
MI
Enumeration date
10/13/2006
Last updated
10/21/2020
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