MEDICARE: TOMMY SWINEY D.O.

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	2084P0800X	Psychiatry Physician	OS 9635	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	28853	OTHER	FL	BCBS OF FL

General Provider Information

NPI Number	:	1467446872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TOMMY SWINEY D.O.

Provider Business Mailing Address
First Line	:	250 JOHN KNOX RD STE 5
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32303-4234
Country	:	US
Telephone Number	:	850-877-3936
Fax Number	:	850-877-3546

Provider Business Practice Location Address
First Line	:	250 JOHN KNOX RD STE 5
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32303-4234
Country	:	US
Telephone Number	:	850-877-3936
Fax Number	:	850-877-3546

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

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	08/19/2011

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Directions to “ TOMMY SWINEY D.O.” Practice Location

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