Provider Demographics
NPI:1386629111
Name:SWIERKOSZ, TOMASZ A (MD, PHD)
Entity Type:Individual
Prefix:
First Name:TOMASZ
Middle Name:A
Last Name:SWIERKOSZ
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3106 NW ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-6123
Mailing Address - Country:US
Mailing Address - Phone:580-250-4278
Mailing Address - Fax:580-581-1548
Practice Address - Street 1:3106 NW ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-6123
Practice Address - Country:US
Practice Address - Phone:580-250-4278
Practice Address - Fax:580-581-1548
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD58689207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD433106100Medicaid
MDG53386Medicare UPIN