Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 2006001825 | MO |
NPI | 1437475027 |
---|---|
Provider Name | Dr. Robert William Swan |
First Address | Grove, OK 74344 |
Second Address | Grove, OK 74344 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2010 |
Last Update Date | 08/04/2010 |