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NPI Code Detail

MEDICARE: JAY A SWEDBERG

MEDICARE: JAY A SWEDBERG
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 Physician3305AWY
2207Q00000XFamily Medicine Physician19719CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2314127OTHERWYBC/BS
3611665900OTHERWYDEPT OF LABOR

General Provider Information

NPI Number : 1467450163
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAY A SWEDBERG
Provider Business Mailing Address
First Line : 6500 E 2ND ST
Second Line : SUITE 200
City : CASPER
State : WY
Zip : 82609-4338
Country : US
Telephone Number : 307-577-5100
Fax Number : 307-234-1201
Provider Business Practice Location Address
First Line : 6500 E 2ND ST
Second Line : SUITE 200
City : CASPER
State : WY
Zip : 82609-4338
Country : US
Telephone Number : 307-577-5100
Fax Number : 307-234-1201
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 02/11/2008

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Directions to “ JAY A SWEDBERG ” Practice Location

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