Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 29426 | CO |
NPI | 1770798449 |
---|---|
Provider Name | William Bryson Swafford |
First Address | Denver, CO 80206-1210 |
Second Address | Denver, CO 80206-1210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
05027008 | (05) | TN |
C46904 | (02) | TN |