Provider Demographics
NPI:1831279462
Name:SWARTHOUT, SCOTT ARTHUR (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ARTHUR
Last Name:SWARTHOUT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8455 N MILLBROOK AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2152
Mailing Address - Country:US
Mailing Address - Phone:559-435-9505
Mailing Address - Fax:
Practice Address - Street 1:8455 N MILLBROOK AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2152
Practice Address - Country:US
Practice Address - Phone:559-435-9505
Practice Address - Fax:559-435-9506
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC21588111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU51602Medicare UPIN