MEDICARE: ELDON SWENSON, M.D., S.C.

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	207L00000X	Anesthesiology Physician
2	207LP2900X	Pain Medicine (Anesthesiology) Physician

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

General Provider Information

NPI Number	:	1588610927
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELDON SWENSON, M.D., S.C.

Provider Business Mailing Address
First Line	:	225 S EXECUTIVE DR
Second Line	:
City	:	BROOKFIELD
State	:	WI
Zip	:	53005-4266
Country	:	US
Telephone Number	:	262-787-4026
Fax Number	:

Provider Business Practice Location Address
First Line	:	3223 S 103RD ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53227-4103
Country	:	US
Telephone Number	:	414-328-5800
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	ELDON SWENSON
Credential	:	M.D.
Telephone Number	:	414-328-5800

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	12/06/2007

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Directions to “ELDON SWENSON, M.D., S.C. ” Practice Location

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