Healthcare Provider Details

I. General information

NPI: 1215156104
Provider Name (Legal Business Name): FRANK PALMER SWEET N.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1731 MESQUITE AVE STE 5
LAKE HAVASU CITY AZ
86403-5653
US

IV. Provider business mailing address

1731 MESQUITE AVE STE 5
LAKE HAVASU CITY AZ
86403-5653
US

V. Phone/Fax

Practice location:
  • Phone: 928-453-9525
  • Fax: 928-453-9519
Mailing address:
  • Phone: 928-453-9525
  • Fax: 928-453-9519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172P00000X
TaxonomyNaprapath
License Number90-413
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: