Healthcare Provider Details

I. General information

NPI: 1255433025
Provider Name (Legal Business Name): JOHN ARTHUR SWANSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1187 N WILLOW AVE STE 103
CLOVIS CA
93611-4411
US

IV. Provider business mailing address

1187 N WILLOW AVE STE 103
CLOVIS CA
93611-4411
US

V. Phone/Fax

Practice location:
  • Phone: 559-285-9344
  • Fax: 559-897-8792
Mailing address:
  • Phone: 559-285-9344
  • Fax: 559-896-8792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberC341450
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: