Provider Demographics
NPI:1588632566
Name:BRETT SWENSON MD, P.L.L.C
Entity Type:Organization
Organization Name:BRETT SWENSON MD, P.L.L.C
Other - Org Name:SWENSON M.D. PREMIER CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:E
Authorized Official - Last Name:SWENSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-751-2345
Mailing Address - Street 1:21803 N SCOTTSDALE RD
Mailing Address - Street 2:125
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-7437
Mailing Address - Country:US
Mailing Address - Phone:480-419-9924
Mailing Address - Fax:480-419-9908
Practice Address - Street 1:8585 E HARTFORD DR STE 900
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-5475
Practice Address - Country:US
Practice Address - Phone:480-751-2345
Practice Address - Fax:480-751-2341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-08
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ109766Medicare PIN