Provider Demographics
NPI:1699736363
Name:SUMMERS, JOHN H (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
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 1:608 NW 9TH ST
Mailing Address - Street 2:STE 2200
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73102-1068
Mailing Address - Country:US
Mailing Address - Phone:405-231-3737
Mailing Address - Fax:405-272-6144
Practice Address - Street 1:608 NW 9TH ST
Practice Address - Street 2:STE 2200
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-1068
Practice Address - Country:US
Practice Address - Phone:405-231-3737
Practice Address - Fax:405-272-6144
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19883207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKP00323742OtherRR MEDICARE
OK100253930AMedicaid
OK500522075OtherMEDICAID GROUP PIN
OK311203YK1NMedicare PIN
OKOK400170Medicare PIN
OKG51585Medicare UPIN