Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 16777 | AZ |
NPI | 1023092640 |
---|---|
Provider Name | Dr. Scott K Swanson |
First Address | Phoenix, AZ 85054-4502 |
Second Address | Phoenix, AZ 85054-4502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2005 |
Last Update Date | 10/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D44562 | (02) |