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NPI Code Detail

MEDICARE: RANDAL W SWENSON MD

MEDICARE: RANDAL W SWENSON MD
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
1207YX0905XOtolaryngology/Facial Plastic Surgery Physician172807-1205UT
2207Y00000XOtolaryngology Physician172807-1205UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578522959
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANDAL W SWENSON MD
Provider Business Mailing Address
First Line : 4000 S 700 E
Second Line : STE 10
City : SLC
State : UT
Zip : 84107-2180
Country : US
Telephone Number : 801-268-4141
Fax Number : 801-268-4141
Provider Business Practice Location Address
First Line : 4000 S 700 E
Second Line : STE 10
City : SLC
State : UT
Zip : 84107-2180
Country : US
Telephone Number : 801-268-4141
Fax Number : 801-268-4141
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2006
Last Update Date : 09/11/2025

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Directions to “ RANDAL W SWENSON MD” Practice Location

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