Provider Demographics
NPI:1912636176
Name:SUMMIT SURGICAL PARTNERS, LLC
Entity type:Organization
Organization Name:SUMMIT SURGICAL PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:PROF
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:DUNCAN
Authorized Official - Last Name:BAIRD
Authorized Official - Suffix:
Authorized Official - Credentials:CSA, MSC, MBA
Authorized Official - Phone:678-951-6270
Mailing Address - Street 1:403 WOODCHASE WAY
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-2052
Mailing Address - Country:US
Mailing Address - Phone:678-951-6270
Mailing Address - Fax:678-623-5943
Practice Address - Street 1:403 WOODCHASE WAY
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-2052
Practice Address - Country:US
Practice Address - Phone:678-951-6270
Practice Address - Fax:678-623-5943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-05
Last Update Date:2022-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty