Provider Demographics
NPI:1477660256
Name:SWIFT, DEBORAH LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:LYNN
Last Name:SWIFT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DEBORAH
Other - Middle Name:LYNN
Other - Last Name:WOLLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 581777
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-0030
Mailing Address - Country:US
Mailing Address - Phone:847-721-6887
Mailing Address - Fax:
Practice Address - Street 1:1860 PENNSYLVANIA AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-3590
Practice Address - Country:US
Practice Address - Phone:707-646-4166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036093309207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036093309Medicaid