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1669477279

NPI Code Detail

MEDICARE: DR. GREGORY DEAN SWEENEY MD

MEDICARE: DR. GREGORY DEAN SWEENEY 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	207P00000X	Emergency Medicine Physician	35083639	OH
2	207P00000X	Emergency Medicine Physician	29042	KY

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669477279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY DEAN SWEENEY MD

Provider Business Mailing Address
First Line	:	PO BOX 18667
Second Line	:
City	:	ERLANGER
State	:	KY
Zip	:	41018-0667
Country	:	US
Telephone Number	:	859-572-3617
Fax Number	:	859-572-2326

Provider Business Practice Location Address
First Line	:	1 MEDICAL VILLAGE DR
Second Line	:
City	:	EDGEWOOD
State	:	KY
Zip	:	41017-3403
Country	:	US
Telephone Number	:	859-572-3617
Fax Number	:	859-572-2326

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

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	07/30/2015

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Directions to “ DR. GREGORY DEAN SWEENEY MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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