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NPI Code Detail

MEDICARE: DR. DONALD FREDERICK SWANSON II DO

MEDICARE: DR. DONALD FREDERICK SWANSON II DO
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
1207Q00000XFamily Medicine PhysicianOS8182FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336193606
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DONALD FREDERICK SWANSON II DO
Provider Business Mailing Address
First Line : 3001 W BLUE STARR DR
Second Line :
City : CLAREMORE
State : OK
Zip : 74017-2544
Country : US
Telephone Number : 239-433-4014
Fax Number : 239-481-6247
Provider Business Practice Location Address
First Line : 3001 W BLUE STARR DR
Second Line :
City : CLAREMORE
State : OK
Zip : 74017-2544
Country : US
Telephone Number : 405-756-1414
Fax Number : 405-756-1162
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2006
Last Update Date : 07/26/2018

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