MEDICARE: KELLY S SWANSON RD

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	133V00000X	Registered Dietitian	1391	OK

General Provider Information

NPI Number	:	1346203700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY S SWANSON RD

Provider Business Mailing Address
First Line	:	1540 N SANTA FE AVE
Second Line	:
City	:	MOORE
State	:	OK
Zip	:	73160-1431
Country	:	US
Telephone Number	:	405-443-8833
Fax Number	:

Provider Business Practice Location Address
First Line	:	4525 S KLEIN AVE
Second Line	:	SUITE 1000
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73109-3845
Country	:	US
Telephone Number	:	405-749-8986
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2006
Last Update Date	:	09/19/2007

Similar Medicare Providers

1457349383 — MARTIN J LOPEZ MD PC
Practice Location Address:

4525 S KLEIN AVE , STE 900
OKLAHOMA CITY, OK
73109-3845

Practice Phone: 405-631-0300
Practice Fax: 405-631-0371

1013905942 — DR. MARTIN J LOPEZ MD
Practice Location Address:

4525 S KLEIN AVE , STE 900
OKLAHOMA CITY, OK
73109-3845

Practice Phone: 405-636-1797
Practice Fax:

1760031868 — ANDREA CHI-LING BAE CCC-SLP
Practice Location Address:

3845 W 4700 S
WEST VALLEY CITY, UT
84129-3454

Practice Phone: 801-840-4360
Practice Fax:

1417397654 — KAITLYN ANDREASON
Practice Location Address:

3845 W 4700 S
WEST VALLEY CITY, UT
84129-3454

Practice Phone: 801-840-4360
Practice Fax:

1255332060 — MR. WILLIAM H BOEHNKE PT
Practice Location Address:

604 W WASHINGTON ST , SUITE B
CARSON CITY, NV
89703-3845

Practice Phone: 775-882-5001
Practice Fax: 775-882-5015

1053384594 — MR. DANIEL SNYDER MSN, FNP-C
Practice Location Address:

3845 BROADWAY BLVD
KANSAS CITY, MO
64111-2507

Practice Phone: 816-561-1629
Practice Fax:

Directions to “ KELLY S SWANSON RD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.