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NPI Code Detail

MEDICARE: RUSSELL E SWANN M.D. PA

MEDICARE: RUSSELL E SWANN M.D. PA
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
1207W00000XOphthalmology PhysicianE5626TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2DC9834OTHERTXRR MEDICARE PIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11619130895OTHERTXNPI
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
41477717759OTHERTXNPI
51841293016OTHERNPI
61073518072OTHERTXNPI

General Provider Information

NPI Number : 1285816850
Entity Type Code : Organization
Provider Name (Legal Business Name) : RUSSELL E SWANN M.D. PA
Provider Business Mailing Address
First Line : 201 LONDONDERRY DR
Second Line :
City : WACO
State : TX
Zip : 76712-7902
Country : US
Telephone Number : 254-772-4499
Fax Number : 254-772-4436
Provider Business Practice Location Address
First Line : 201 LONDONDERRY DR
Second Line :
City : WACO
State : TX
Zip : 76712-7902
Country : US
Telephone Number : 254-772-4499
Fax Number : 254-772-4436
Authorized Official
Title or Position : INSURANCE BILLING
Name : SHAYE J WOOTEN
Credential :
Telephone Number : 254-772-4499
Provider Enumeration Date : 12/05/2007
Last Update Date : 10/23/2012

Similar Medicare Providers

1841293016 — RUSSELL E SWANN M.D.
Practice Location Address:
201 LONDONDERRY DR
WACO, TX
76712-7902
Practice Phone: 254-772-4499
Practice Fax: 254-772-4436
1043540677 — TED LAWSON DDS PLLC
Practice Location Address:
2012 LAKE AIR DR STE A
WACO, TX
76710-7902
Practice Phone: 254-751-7100
Practice Fax: 254-751-7144
1629414065 — SHANNON GARITTY MD
Practice Location Address:
205 WOODHEW DR STE 220
WACO, TX
76712-6679
Practice Phone: 254-245-9175
Practice Fax:
1528606357 — ESMPT, LLC
Practice Location Address:
7135 NEW SANGER AVE , SUITE 502
WACO, TX
76712
Practice Phone: 254-325-9817
Practice Fax: 254-754-2667
1457884306 — ADAM BEYER D.O.
Practice Location Address:
50 HILLCREST MEDICAL BLVD STE 303
WACO, TX
76712-8955
Practice Phone: 254-202-0480
Practice Fax: 254-202-0488
1982607735 — WACO CARDIOLOGY ASSOCIATES
Practice Location Address:
7125 NEW SANGER AVE STE A
WACO, TX
76712-4054
Practice Phone: 254-399-5400
Practice Fax: 254-772-8669

Directions to “RUSSELL E SWANN M.D. PA ” Practice Location

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