Provider Demographics
NPI:1467446872
Name:SWINEY, TOMMY (DO)
Entity Type:Individual
Prefix:
First Name:TOMMY
Middle Name:
Last Name:SWINEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 JOHN KNOX RD STE 5
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-4234
Mailing Address - Country:US
Mailing Address - Phone:850-877-3936
Mailing Address - Fax:850-877-3546
Practice Address - Street 1:250 JOHN KNOX RD STE 5
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-4234
Practice Address - Country:US
Practice Address - Phone:850-877-3936
Practice Address - Fax:850-877-3546
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 96352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL273594600Medicaid
FL28853OtherBCBS OF FL
FL28853OtherBCBS OF FL
U6730ZMedicare ID - Type Unspecified
U6730WMedicare ID - Type Unspecified
U6730XMedicare ID - Type Unspecified
U6730VMedicare ID - Type Unspecified
FL273594600Medicaid