Provider Demographics
NPI:1235392820
Name:CRUM DOGGWILER AND STEFANKO LTD A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:CRUM DOGGWILER AND STEFANKO LTD A PROFESSIONAL CORPORATION
Other - Org Name:SUMMIT RIDGE MEDICAL CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NADINE
Authorized Official - Middle Name:R
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-624-2200
Mailing Address - Street 1:4791 SUMMIT RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-7917
Mailing Address - Country:US
Mailing Address - Phone:775-624-2200
Mailing Address - Fax:775-624-2211
Practice Address - Street 1:4791 SUMMIT RIDGE DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-7917
Practice Address - Country:US
Practice Address - Phone:775-624-2200
Practice Address - Fax:775-624-2211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care