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NPI Code Detail

MEDICARE: SWAN UROGYNECOLOGY PC

MEDICARE: SWAN UROGYNECOLOGY PC
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
1261QM2500XMedical Specialty Clinic/CenterMD0000029235TN

General Provider Information

NPI Number : 1134491814
Entity Type Code : Organization
Provider Name (Legal Business Name) : SWAN UROGYNECOLOGY PC
Provider Business Mailing Address
First Line : 329 21ST AVE N
Second Line : SUITE 1
City : NASHVILLE
State : TN
Zip : 37203-1839
Country : US
Telephone Number : 615-515-9180
Fax Number : 615-712-7647
Provider Business Practice Location Address
First Line : 801 HILL ST
Second Line :
City : SPRINGFIELD
State : TN
Zip : 37172-2951
Country : US
Telephone Number : 615-515-9180
Fax Number : 615-712-7647
Authorized Official
Title or Position : PHYSICIAN
Name : MICHAEL C SWAN
Credential : MD
Telephone Number : 615-515-9180
Provider Enumeration Date : 01/27/2012
Last Update Date : 01/27/2012

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Directions to “SWAN UROGYNECOLOGY PC ” Practice Location

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