Provider Demographics
NPI:1447841770
Name:SUMMIT ANESTHESIA SERVICES LLC
Entity type:Organization
Organization Name:SUMMIT ANESTHESIA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:B
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-647-4100
Mailing Address - Street 1:2404 SW OLD PORT RD
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64082-7808
Mailing Address - Country:US
Mailing Address - Phone:913-647-4100
Mailing Address - Fax:913-647-4120
Practice Address - Street 1:6815 FRONTAGE RD STE B
Practice Address - Street 2:
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66204-1555
Practice Address - Country:US
Practice Address - Phone:913-318-3800
Practice Address - Fax:913-624-9971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-29
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty