Provider Demographics
NPI:1386633741
Name:SWINFORD, JOHN WILLIAM (OD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WILLIAM
Last Name:SWINFORD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:3430 N 1ST AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-1803
Mailing Address - Country:US
Mailing Address - Phone:520-293-2443
Mailing Address - Fax:520-293-9442
Practice Address - Street 1:3430 N 1ST AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-1803
Practice Address - Country:US
Practice Address - Phone:520-293-2443
Practice Address - Fax:520-293-9442
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2009-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ543152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0655220001Medicare NSC
AZAZ02127Medicare PIN