Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 23325 | NE |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 23325 | NE |
NPI | 1417077900 |
---|---|
Provider Name | Scott A Swanson |
First Address | Lincoln, NE 68510-2471 |
Second Address | Lincoln, NE 68510-2471 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2007 |
Last Update Date | 08/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
093416 | GROUP MEDICARE # (01) | NE |
1285683870 | (05) | IA |
47070309913 | (05) | NE |