Provider Demographics
NPI:1710006358
Name:SWIFT, CASEY (OD)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:
Last Name:SWIFT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6999 S MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-2035
Mailing Address - Country:US
Mailing Address - Phone:918-461-2020
Mailing Address - Fax:918-461-2022
Practice Address - Street 1:6999 S MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-2035
Practice Address - Country:US
Practice Address - Phone:918-461-2020
Practice Address - Fax:918-461-2022
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2261152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKU82445Medicare UPIN