Provider Demographics
NPI:1821299801
Name:BROCKWAY, STEPHEN SWIFT (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:SWIFT
Last Name:BROCKWAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6524 E ROCKAWAY HILLS DR
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331-7609
Mailing Address - Country:US
Mailing Address - Phone:928-684-3926
Mailing Address - Fax:928-684-4037
Practice Address - Street 1:1655 N TEGNER ST
Practice Address - Street 2:
Practice Address - City:WICKENBURG
Practice Address - State:AZ
Practice Address - Zip Code:85390-1461
Practice Address - Country:US
Practice Address - Phone:928-684-3926
Practice Address - Fax:928-684-4037
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ177592084A0401X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry