Provider Demographics
NPI:1437259645
Name:SWEIGARD, TIMOTHY ALLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:ALLEN
Last Name:SWEIGARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2934 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-1027
Mailing Address - Country:US
Mailing Address - Phone:860-657-8800
Mailing Address - Fax:860-633-7252
Practice Address - Street 1:2934 MAIN ST
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-1027
Practice Address - Country:US
Practice Address - Phone:860-657-8800
Practice Address - Fax:860-633-7252
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000956111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT050000956CT03OtherANTHEM BC/BS
CTP2079775OtherOXFORD HEALTHPLAN
CTCT00956OtherLANDMARK HEALTHCARE
CTU20483Medicare UPIN
CT050000956CT03OtherANTHEM BC/BS