Organization
SUMMIT HEALTHCARE MEDICAL ASSOCIATES
Active
Parent organization
SUMMIT HEALTHCARE ASSOCIATION
Other names
Family Medicine at Bison Ranch
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUMMIT HEALTHCARE ASSOCIATION
Authorized official
JILL BLUSE (HEALTH PLAN CREDENTIALING COORDINAT)
(928) 537-6393
Entity
Organization
Contact information
Practice address
2352 QUARTER HORSE TRAIL, OVERGAARD, AZ 85933
(928) 535-3616
(928) 532-2156
Mailing address
2200 E SHOW LOW LAKE RD, SHOW LOW, AZ 85901-7831
(928) 535-3616
(928) 532-2156
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
H0132
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
950222
—
AZ
Enumeration date
04/19/2007
Last updated
08/11/2025
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