Provider Demographics
NPI:1972500593
Name:SWOPE MEDICAL GROUP INC
Entity Type:Organization
Organization Name:SWOPE MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:BRITTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-274-6000
Mailing Address - Street 1:4401 W MEMORIAL RD STE 121
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-1722
Mailing Address - Country:US
Mailing Address - Phone:800-477-8909
Mailing Address - Fax:405-751-3183
Practice Address - Street 1:155 GLASSON WAY
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5723
Practice Address - Country:US
Practice Address - Phone:530-470-8377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-29
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA1009678207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0085990Medicaid
CAGR0085990Medicaid