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General NPI Number Information
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NPI Number | 1225096233
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Entity Type | Individual
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Provider Name | KERRY JAY SWEET D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 12/09/2013
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Provider Practice Location Address
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Address Line | MADIGAN ARMY MEDICAL CENTER 9040 REID ST., ATTN: MCHJ-QCR
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City | TACOMA
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State | WA
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Zip | 98431-1100
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Country | US
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Telephone | 253-968-2252
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Fax | 253-968-3278
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Provider Business Mailing Address
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Address Line | 4501 68TH AVE W
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98466-4919
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Country | US
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Telephone | 253-565-3437
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 127
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License Number State | MT
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