| Summit Podiatry Center Pllc | |
| 
					15095 Dedeaux Road, Gulfport, MS 39503-3284  | |
| (228) 832-6008 | |
| (228) 832-6009 | 
| Full Name | Summit Podiatry Center Pllc | 
|---|---|
| Type | Facility | 
| Speciality | Podiatrist - Foot & Ankle Surgery | 
| Location | 15095 Dedeaux Road, Gulfport, Mississippi | 
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1407091168 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | (* (Not Available)) | Primary | 
| Mailing Address | Practice Location Address | 
|---|---|
| Summit Podiatry Center Pllc 15095 Dedeaux Road, Gulfport, MS 39503-3284 Ph: (228) 832-6008  | Summit Podiatry Center Pllc 15095 Dedeaux Road, Gulfport, MS 39503-3284 Ph: (228) 832-6008  | 
Edward Robert Cohen, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 12056 Mobile Ave, Gulfport, MS 39503 Phone: 228-832-4475 Fax: 228-832-1512  | |
Joann Orphanos, DPM Podiatrist Medicare: Medicare Enrolled Practice Location: 15095 Dedeaux Road, Gulfport, MS 39503 Phone: 228-243-1238 Fax: 228-206-0503  |