Basic Information
| Provider Information | |||||||||
| NPI: | 1922344050 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SUMMA PHYSICIANS INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1077 GORGE BLVD | ||||||||
| Address2: | |||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443102408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2343125873 | ||||||||
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| Practice Location | |||||||||
| Address1: | 444 N MAIN ST | ||||||||
| Address2: | SUITE 420 | ||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443103110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3303795094 | ||||||||
| FaxNumber: | 3303795095 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/18/2012 | ||||||||
| LastUpdateDate: | 11/20/2017 | ||||||||
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| AuthorizedOfficialLastName: | ALEXANDER-COOK | ||||||||
| AuthorizedOfficialFirstName: | LYDIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2343125873 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical | 103TC0700X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.