Provider Demographics
NPI:1265630958
Name:SWIRAT, THEODORE BEN (MD)
Entity Type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:BEN
Last Name:SWIRAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:TED
Other - Middle Name:
Other - Last Name:SWIRAT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4000 BUECHEL BANK RD
Mailing Address - Street 2:AP3-170 APPLIANCE PARK
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40225-0001
Mailing Address - Country:US
Mailing Address - Phone:502-452-0333
Mailing Address - Fax:502-452-0454
Practice Address - Street 1:4000 BUECHEL BANK RD
Practice Address - Street 2:AP3-170 APPLIANCE PARK
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40225-0001
Practice Address - Country:US
Practice Address - Phone:502-452-0333
Practice Address - Fax:502-452-0454
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY29446207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine