Provider Demographics
NPI:1255433025
Name:SWANSON, JOHN ARTHUR (MD)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ARTHUR
Last Name:SWANSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1187 N WILLOW AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-4411
Mailing Address - Country:US
Mailing Address - Phone:559-285-9344
Mailing Address - Fax:559-896-8792
Practice Address - Street 1:1187 N WILLOW AVE STE 103
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-4411
Practice Address - Country:US
Practice Address - Phone:559-285-9344
Practice Address - Fax:559-897-8792
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2024-05-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC341450207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A35515Medicare UPIN