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NPI Code Detail

MEDICARE: TIMOTHY R SWANSON DPT

MEDICARE: TIMOTHY R SWANSON DPT
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
1225100000XPhysical Therapist1104160KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1740595453
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY R SWANSON DPT
Provider Business Mailing Address
First Line : 12112 W KELLOGG ST
Second Line :
City : WICHITA
State : KS
Zip : 67235-1100
Country : US
Telephone Number : 316-440-1100
Fax Number : 316-858-3201
Provider Business Practice Location Address
First Line : 2311 S KANSAS RD
Second Line :
City : NEWTON
State : KS
Zip : 67114-9032
Country : US
Telephone Number : 316-283-7187
Fax Number : 316-283-7189
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2010
Last Update Date : 03/17/2026

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