Provider Demographics
NPI:1659401511
Name:ALPINE FAMILY MEDICINE, LLC
Entity Type:Organization
Organization Name:ALPINE FAMILY MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:SWANSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:775-331-5200
Mailing Address - Street 1:1959 E PRATER WAY
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-8938
Mailing Address - Country:US
Mailing Address - Phone:775-331-5200
Mailing Address - Fax:775-331-5202
Practice Address - Street 1:1959 E PRATER WAY
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434-8938
Practice Address - Country:US
Practice Address - Phone:775-331-5200
Practice Address - Fax:775-331-5202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVG57687Medicare UPIN
NVV104125Medicare PIN