| Summit Medical Group, Llc | |
|
12633 Se Oatfield Rd Milwaukie OR 97222-6939 | |
| (503) 307-1422 | |
| Not Available |
| Full Name | Summit Medical Group, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 12633 Se Oatfield Rd, Milwaukie, Oregon |
| Authorized Official Name and Position | Judith A Lindsey (PHYSICIAN AND SURGEON) |
| Authorized Official Contact | 5033071422 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Medical Group, Llc Po Box 22165 Milwaukie OR 97269-2165 Ph: (503) 307-1422 | Summit Medical Group, Llc 12633 Se Oatfield Rd Milwaukie OR 97222-6939 Ph: (503) 307-1422 |
| NPI Number | 1235344060 |
|---|---|
| Provider Enumeration Date | 05/14/2007 |
| Last Update Date | 10/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235344060 | NPI | - | NPPES |
| 1932162880 | Other | OR | MEDICARE NPI |
| 1235344060 | Other | OR | MEDICARE NPI |
| 287403 | Medicaid | OR | |
| 715535-81 | Other | OR | OREGON STATE BUSINESS LIC |
| 1922074160 | Other | OR | MEDICARE NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 17146 (Oregon) | Primary |
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