Provider Demographics
NPI:1417120023
Name:SWICORD, ROBERT LUTHER (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LUTHER
Last Name:SWICORD
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 1:14300 N PENNSYLVANIA AVE
Mailing Address - Street 2:# 57
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-6066
Mailing Address - Country:US
Mailing Address - Phone:405-748-4418
Mailing Address - Fax:
Practice Address - Street 1:14300 N PENNSYLVANIA AVE
Practice Address - Street 2:# 57
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-6066
Practice Address - Country:US
Practice Address - Phone:405-748-4418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-04
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK210962083X0100X
GA0324802083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine