Provider Demographics
NPI:1568459295
Name:SWARNER, DENNIS A (OD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:A
Last Name:SWARNER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 S WILLOW ST
Mailing Address - Street 2:UNIT #108
Mailing Address - City:KENAI
Mailing Address - State:AK
Mailing Address - Zip Code:99611-7744
Mailing Address - Country:US
Mailing Address - Phone:907-283-7575
Mailing Address - Fax:907-283-6156
Practice Address - Street 1:110 S WILLOW ST
Practice Address - Street 2:UNIT #108
Practice Address - City:KENAI
Practice Address - State:AK
Practice Address - Zip Code:99611-7744
Practice Address - Country:US
Practice Address - Phone:907-283-7575
Practice Address - Fax:907-283-6156
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK072152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKOP0072Medicaid
AK0005950469OtherAETNA
AK410026661OtherRAILROAD MEDICARE
AKT67085Medicare UPIN
AKOP0072Medicaid