Basic Information
| Provider Information | |||||||||
| NPI: | 1376842260 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SUMMIT PAIN SPECIALISTS, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4302 ALLEN RD STE 300 | ||||||||
| Address2: | |||||||||
| City: | STOW | ||||||||
| State: | OH | ||||||||
| PostalCode: | 442241070 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3309457246 | ||||||||
| FaxNumber: | 3309459920 | ||||||||
| Practice Location | |||||||||
| Address1: | 4302 ALLEN RD STE 300 | ||||||||
| Address2: | |||||||||
| City: | STOW | ||||||||
| State: | OH | ||||||||
| PostalCode: | 442241070 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3309457246 | ||||||||
| FaxNumber: | 3309459920 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/18/2011 | ||||||||
| LastUpdateDate: | 03/18/2011 | ||||||||
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| AuthorizedOfficialLastName: | BRESSI | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
| AuthorizedOfficialMiddleName: | PATRICK | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3309459551 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | COA12058-NP | OH | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.