MEDICARE: DR. KERRY K SWINDLE MD

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	207Q00000X	Family Medicine Physician	16217	AZ

General Provider Information

NPI Number	:	1598710675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KERRY K SWINDLE MD

Provider Business Mailing Address
First Line	:	5055 E BROADWAY BLVD
Second Line	:	STE A-100 ARIZONA COMMUNITY PHYSICIANS PC
City	:	TUCSON
State	:	AZ
Zip	:	85711-3640
Country	:	US
Telephone Number	:	520-327-0460
Fax Number	:	520-795-0225

Provider Business Practice Location Address
First Line	:	6565 E CARONDELET DR
Second Line	:	#215 DESERT SPRING FAMILY CARE
City	:	TUCSON
State	:	AZ
Zip	:	85710-2157
Country	:	US
Telephone Number	:	520-547-1887
Fax Number	:	520-547-1893

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	03/01/2010

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