Provider Demographics
NPI:1528630456
Name:SUMMERHILL MEDICAL LLC
Entity type:Organization
Organization Name:SUMMERHILL MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-326-5275
Mailing Address - Street 1:1855 E MAIN ST STE 14-155
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29307-2309
Mailing Address - Country:US
Mailing Address - Phone:864-326-5275
Mailing Address - Fax:
Practice Address - Street 1:3372 LAURENS ROAD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-2930
Practice Address - Country:US
Practice Address - Phone:864-537-4600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-12
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No283X00000XHospitalsRehabilitation HospitalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC386870Medicaid