Provider Demographics
NPI:1992868483
Name:SWORDS, ELIZABETH (OD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:SWORDS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5250 EAST U.S. HWY 36
Mailing Address - Street 2:#240
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-9142
Mailing Address - Country:US
Mailing Address - Phone:317-745-3377
Mailing Address - Fax:317-745-7736
Practice Address - Street 1:5250 EAST U.S. HWY 36
Practice Address - Street 2:#240
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-9142
Practice Address - Country:US
Practice Address - Phone:317-745-3377
Practice Address - Fax:317-745-7736
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18002152A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN0508800001OtherDME PTAN
T69251Medicare UPIN
IN0508800001Medicare NSC
IN342040Medicare ID - Type Unspecified