Provider Demographics
NPI:1518985910
Name:SWANCUTT, PATRICK S (PT)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:S
Last Name:SWANCUTT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 S. SCOTT BLVD.
Mailing Address - Street 2:STE.1
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240
Mailing Address - Country:US
Mailing Address - Phone:319-354-2429
Mailing Address - Fax:319-338-5775
Practice Address - Street 1:1120 TALL GRASS AVE.
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:IA
Practice Address - Zip Code:52340
Practice Address - Country:US
Practice Address - Phone:319-545-2407
Practice Address - Fax:319-545-2315
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03782208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA38603OtherWELLMARK BCBS
IA0468256Medicaid
IAF232553OtherMIDLANDS CHOICE
IAP00279681OtherRAILROAD MEDICARE
IAF232553OtherMIDLANDS CHOICE