| Summit Medical Providers LLC | |
|
2205 E Riverside Dr Eagle ID 83616-7620 | |
| (801) 867-9760 | |
| (801) 880-4400 |
| Full Name | Summit Medical Providers LLC |
|---|---|
| Speciality | General Practice |
| Location | 2205 E Riverside Dr, Eagle, Idaho |
| Authorized Official Name and Position | Rachel Fletcher (OWNER) |
| Authorized Official Contact | 8018679760 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Medical Providers LLC 2205 E Riverside Dr Eagle ID 83616-7620 Ph: (801) 867-9760 | Summit Medical Providers LLC 2205 E Riverside Dr Eagle ID 83616-7620 Ph: (801) 867-9760 |
| NPI Number | 1164397410 |
|---|---|
| Provider Enumeration Date | 10/07/2025 |
| Last Update Date | 10/07/2025 |
| Certification Date | 10/07/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164397410 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
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