Provider Demographics
NPI:1124203922
Name:SUMMERS, JOSEPH D (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:D
Last Name:SUMMERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16838 E PALISADES BLVD
Mailing Address - Street 2:C153
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-3786
Mailing Address - Country:US
Mailing Address - Phone:480-816-3131
Mailing Address - Fax:480-816-3136
Practice Address - Street 1:16838 E PALISADES BLVD
Practice Address - Street 2:C153
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-3786
Practice Address - Country:US
Practice Address - Phone:480-816-3131
Practice Address - Fax:480-816-3136
Is Sole Proprietor?:No
Enumeration Date:2007-12-31
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ37740207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine