Provider Demographics
NPI:1407041247
Name:SUMMA PHYSICIANS LLC
Entity type:Organization
Organization Name:SUMMA PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER, PAYER ENROLLMENT
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:234-312-5691
Mailing Address - Street 1:1077 GORGE BLVD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44310-2408
Mailing Address - Country:US
Mailing Address - Phone:234-312-5873
Mailing Address - Fax:
Practice Address - Street 1:1 PARK WEST BLVD STE 310
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-4218
Practice Address - Country:US
Practice Address - Phone:330-836-8545
Practice Address - Fax:330-836-8598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2778294Medicaid
OH2778294Medicaid