MEDICARE: SWEARINGEN AND BURTON LLC

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	152W00000X	Optometrist	NA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	107638	OTHER	MO	BC/BS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	DA0028	OTHER	MO	RR

General Provider Information

NPI Number	:	1538228226
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SWEARINGEN AND BURTON LLC

Provider Business Mailing Address
First Line	:	808 GULF ST
Second Line	:
City	:	LAMAR
State	:	MO
Zip	:	64759-1239
Country	:	US
Telephone Number	:	417-682-3301
Fax Number	:	417-682-2409

Provider Business Practice Location Address
First Line	:	808 GULF ST
Second Line	:
City	:	LAMAR
State	:	MO
Zip	:	64759-1239
Country	:	US
Telephone Number	:	417-682-3301
Fax Number	:	417-682-2409

Authorized Official
Title or Position	:	CO-OWNER
Name	:	DR. GERALD B. SWEARINGEN
Credential	:	O.D.
Telephone Number	:	417-682-3301

Provider Enumeration Date	:	12/08/2006
Last Update Date	:	11/17/2010

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Directions to “SWEARINGEN AND BURTON LLC ” Practice Location

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