Provider Demographics
NPI:1598767998
Name:SWAIN, BRIAN TAU (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:TAU
Last Name:SWAIN
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 1:300 S 8TH ST
Mailing Address - Street 2:SUITE 401E
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-2400
Mailing Address - Country:US
Mailing Address - Phone:270-753-2444
Mailing Address - Fax:270-767-3644
Practice Address - Street 1:300 S 8TH ST
Practice Address - Street 2:SUITE 401E
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2400
Practice Address - Country:US
Practice Address - Phone:270-753-2444
Practice Address - Fax:270-767-3644
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY37663208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4063914OtherTN BC/BS PIN #
KY5955989OtherCIGNA PIN #
KY611330797001OtherTRICARE GRP #
KY64062623Medicaid
KY65933855Medicaid
KY000000290295OtherBC/BS PIN #
KYCB3611OtherRR MEDICARE GRP #
KYP00001579OtherRR MEDICARE PIN #
KY1801902341OtherGROUP NPI
KYP00001579OtherRR MEDICARE PIN #
KY5955989OtherCIGNA PIN #
KYH80143Medicare UPIN