Provider Demographics
NPI:1093087108
Name:SWAN MOUNTAIN WOMEN'S CENTER, PC
Entity Type:Organization
Organization Name:SWAN MOUNTAIN WOMEN'S CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:CATRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-649-0708
Mailing Address - Street 1:PO BOX 9667
Mailing Address - Street 2:
Mailing Address - City:BRECKENRIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80424-9016
Mailing Address - Country:US
Mailing Address - Phone:719-649-0708
Mailing Address - Fax:
Practice Address - Street 1:16172 HIGHWAY 9
Practice Address - Street 2:
Practice Address - City:BRECKENRIDGE
Practice Address - State:CO
Practice Address - Zip Code:80424-8959
Practice Address - Country:US
Practice Address - Phone:719-649-0708
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-04
Last Update Date:2012-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO32699207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty