Provider Demographics
NPI:1336124817
Name:SWAIN, JAMES M (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:SWAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10210 N 92ND ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4509
Mailing Address - Country:US
Mailing Address - Phone:480-882-7460
Mailing Address - Fax:
Practice Address - Street 1:10210 N 92ND ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4509
Practice Address - Country:US
Practice Address - Phone:480-882-7460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN45873208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ020043146OtherRAILROAD MEDICARE
MN380065100Medicaid
AZ465163Medicaid
AZ86080015085259A506OtherTRIWEST
MNP00646042OtherMEDICARE, RAILROAD
MN020002493Medicare PIN
G97257Medicare UPIN
MN380065100Medicaid