MEDICARE: JOHN BARNETT SWOFFORD D.O.

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	207LP2900X	Pain Medicine (Anesthesiology) Physician	02001363	IN
2	208VP0000X	Pain Medicine Physician	02001363A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000373172	OTHER	IN	ANTHEM

General Provider Information

NPI Number	:	1326040254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN BARNETT SWOFFORD D.O.

Provider Business Mailing Address
First Line	:	PO BOX 3056
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46206-3056
Country	:	US
Telephone Number	:	317-567-2180
Fax Number	:	317-567-2191

Provider Business Practice Location Address
First Line	:	5445 E 16TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46218-4869
Country	:	US
Telephone Number	:	317-355-4358
Fax Number	:	317-351-2428

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	11/25/2009

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