Provider Demographics
NPI:1891011631
Name:SWENDSEN, CARL SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:SCOTT
Last Name:SWENDSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SCOTT
Other - Middle Name:
Other - Last Name:SWENDSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2940 N CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1160
Mailing Address - Country:US
Mailing Address - Phone:719-635-7321
Mailing Address - Fax:719-635-2510
Practice Address - Street 1:2940 N CIRCLE DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1160
Practice Address - Country:US
Practice Address - Phone:719-635-7321
Practice Address - Fax:719-635-2510
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP3253207R00000X
CODR.0056167207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine