MEDICARE: MCSWAIN WILLIAMSON PLLC

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
1	208D00000X	General Practice Physician	DO1502	NV
2	208D00000X	General Practice Physician	DW009333	NV

General Provider Information

NPI Number	:	1154691814
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCSWAIN WILLIAMSON PLLC

Provider Business Mailing Address
First Line	:	2225 E FLAMINGO RD
Second Line	:	STE 105
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5125
Country	:	US
Telephone Number	:	702-419-7529
Fax Number	:	702-538-8151

Provider Business Practice Location Address
First Line	:	2225 E FLAMINGO RD
Second Line	:	STE 105
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5125
Country	:	US
Telephone Number	:	702-419-7529
Fax Number	:	702-538-8151

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. SHARON WILLIAMSON
Credential	:
Telephone Number	:	248-442-0111

Provider Enumeration Date	:	01/11/2012
Last Update Date	:	01/11/2012

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