Provider Demographics
| NPI: | 1306840814 |
|---|---|
| Name: | SUMMIT PHYSICIAN SERVICES |
| Entity type: | Organization |
| Organization Name: | SUMMIT PHYSICIAN SERVICES |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | ASST DIR BILLING INS ENROLLMENT |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | AMY |
| Authorized Official - Middle Name: | C |
| Authorized Official - Last Name: | HOBBS |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 717-217-4229 |
| Mailing Address - Street 1: | 785 5TH AVENUE |
| Mailing Address - Street 2: | SUITE 3 |
| Mailing Address - City: | CHAMBERSBURG |
| Mailing Address - State: | PA |
| Mailing Address - Zip Code: | 17201-4232 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 717-263-9555 |
| Mailing Address - Fax: | 717-217-4218 |
| Practice Address - Street 1: | 785 5TH AVENUE |
| Practice Address - Street 2: | SUITE 3 |
| Practice Address - City: | CHAMBERSBURG |
| Practice Address - State: | PA |
| Practice Address - Zip Code: | 17201-4232 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 717-263-9555 |
| Practice Address - Fax: | 717-217-4218 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2005-06-13 |
| Last Update Date: | 2019-07-09 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
| No | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | Group - Multi-Specialty | |
| No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
| No | 2084P0804X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry | Group - Multi-Specialty |
| No | 2084P0805X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Geriatric Psychiatry | Group - Multi-Specialty |
| No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
| No | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | Group - Multi-Specialty | |
| No | 261QU0200X | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care | Group - Multi-Specialty |
| No | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Multi-Specialty | |
| No | 207LP2900X | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | Group - Multi-Specialty |
| No | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | Group - Multi-Specialty | |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
| No | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| PA | 1007307260034 | Other | MEDICAID GROUP # (MD) |
| PA | 100730726 0036 | Other | MEDICAID GROUP # - SUMMIT ANESTHESIA |
| PA | 050514 | Medicare PIN | |
| PA | 1007307260034 | Other | MEDICAID GROUP # (MD) |
| PA | 1007307260037 | Other | MEDICAID GROUP # (PAIN MED) |
| PA | 1007307260038 | Other | MEDICAID GROUP # (ROSIE) |
| PA | 1007307260036 | Other | MEDICAID GROUP # (AFC) |
| PA | 1007307260040 | Other | GROUP MEDICAID # (INTERVENTIONALISTS) |
