MEDICARE: DR. HARVEY CLARK SWANSON M.D.

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	207R00000X	Internal Medicine Physician	4563	MT

General Provider Information

NPI Number	:	1568486702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARVEY CLARK SWANSON M.D.

Provider Business Mailing Address
First Line	:	66 CLAREMONT ST
Second Line	:	SUITE B
City	:	KALISPELL
State	:	MT
Zip	:	59901-3518
Country	:	US
Telephone Number	:	406-751-5980
Fax Number	:	406-751-5981

Provider Business Practice Location Address
First Line	:	66 CLAREMONT ST
Second Line	:	SUITE B
City	:	KALISPELL
State	:	MT
Zip	:	59901-3518
Country	:	US
Telephone Number	:	406-751-5980
Fax Number	:	406-751-5981

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	07/08/2007

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