MEDICARE: SWAN MOUNTAIN WOMEN'S CENTER, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	32699	CO

General Provider Information

NPI Number	:	1093087108
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SWAN MOUNTAIN WOMEN'S CENTER, PC

Provider Business Mailing Address
First Line	:	16172 CO-9
Second Line	:
City	:	BRECKENRIDGE
State	:	CO
Zip	:	80424-9016
Country	:	US
Telephone Number	:	970-305-4009
Fax Number	:

Provider Business Practice Location Address
First Line	:	16172 HIGHWAY 9
Second Line	:
City	:	BRECKENRIDGE
State	:	CO
Zip	:	80424-8959
Country	:	US
Telephone Number	:	719-649-0708
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHELBY ELIZABETH OSBORNE
Credential	:	DO
Telephone Number	:	970-423-8840

Provider Enumeration Date	:	02/04/2012
Last Update Date	:	05/13/2026

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