Provider Demographics
NPI:1578569182
Name:SWENSON, BRIAN ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:ROBERT
Last Name:SWENSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 CARGILE LN
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-3206
Mailing Address - Country:US
Mailing Address - Phone:615-352-3822
Mailing Address - Fax:
Practice Address - Street 1:204 CARGILE LN
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-3206
Practice Address - Country:US
Practice Address - Phone:615-352-3822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN127482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3199066Medicare ID - Type Unspecified
TNB04834Medicare UPIN