MEDICARE: SWOPE MEDICAL GROUP INC

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	CA1009678	CA

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	:	1972500593
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SWOPE MEDICAL GROUP INC

Provider Business Mailing Address
First Line	:	4401 W MEMORIAL RD STE 121
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73134-1722
Country	:	US
Telephone Number	:	800-477-8909
Fax Number	:	405-751-3183

Provider Business Practice Location Address
First Line	:	155 GLASSON WAY
Second Line	:
City	:	GRASS VALLEY
State	:	CA
Zip	:	95945-5723
Country	:	US
Telephone Number	:	530-470-8377
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	JOSEPH CRAIG BRITTON
Credential	:	MD
Telephone Number	:	530-274-6000

Provider Enumeration Date	:	06/29/2005
Last Update Date	:	10/26/2020

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