Provider Demographics
NPI:1699854018
Name:SWOPE, SCOTT R (DO)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:R
Last Name:SWOPE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 S EAST ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-2378
Mailing Address - Country:US
Mailing Address - Phone:513-695-1479
Mailing Address - Fax:513-695-2402
Practice Address - Street 1:416 S EAST ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-2378
Practice Address - Country:US
Practice Address - Phone:513-695-1479
Practice Address - Fax:513-695-2402
Is Sole Proprietor?:No
Enumeration Date:2006-11-05
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34001354207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHA74718Medicare UPIN