Healthcare Provider Details

I. General information

NPI: 1174576029
Provider Name (Legal Business Name): CAROL ANN SWANSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 03/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 N LA CHOLLA BLVD CASAS ADOBES PEDIATRICS
TUCSON AZ
85741
US

IV. Provider business mailing address

5055 E BROADWAY BLVD STE A-100 ARIZONA COMMUNITY PHYSICIANS PC
TUCSON AZ
85711-3640
US

V. Phone/Fax

Practice location:
  • Phone: 520-751-3675
  • Fax: 520-547-5767
Mailing address:
  • Phone: 520-327-0460
  • Fax: 520-795-0225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20031
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: