Individual
MELISSA M SUMMERFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3121 4TH ST SW, MASON CITY, IA 50401-1581
(757) 423-8861
(757) 423-0727
Mailing address
PO BOX 1877, MASON CITY, IA 50402-1877
(641) 423-8861
(641) 423-0727
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
0101247778
VA
207W00000X
Ophthalmology Physician
Primary
39755
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-019
TRICARE/CHAMPUS
VA
01
—
10064693
OPTIMA HEALTH
VA
05
—
1609096478
—
VA
01
—
415451
ANTHEM BC/BS
VA
05
—
5915878
—
NC
01
—
PAR
USA MANAGED CARE
VA
Enumeration date
04/26/2007
Last updated
11/29/2021
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