Provider Demographics
NPI:1033604905
Name:SWANEY, RICHARD DALE (DO)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:DALE
Last Name:SWANEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7710 MERCY RD STE 301
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2354
Mailing Address - Country:US
Mailing Address - Phone:402-280-4214
Mailing Address - Fax:574-884-4533
Practice Address - Street 1:7710 MERCY RD STE 301
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2354
Practice Address - Country:US
Practice Address - Phone:402-280-4214
Practice Address - Fax:574-884-4533
Is Sole Proprietor?:No
Enumeration Date:2018-06-24
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018021585207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine