Brian Willis Swanton, MD | |
4294 Laurel Dr, Lake Odessa, MI 48849-9423 | |
(616) 374-7660 | |
(616) 374-0270 |
Full Name | Brian Willis Swanton |
---|---|
Gender | Male |
Speciality | General Practice |
Location | 4294 Laurel Dr, Lake Odessa, Michigan |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1972612547 | NPI | - | NPPES |
2817978 | Medicaid | MI | |
382376508 | Other | MI | TAX IDENTIFICATION |
0348293 | Other | MI | BLUE CROSS BLUE SHIELD MI |
BS035130 | Other | MI | STATE LICENSE MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | 4301035130 (Michigan) | Primary |
Mailing Address | Practice Location Address |
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Brian Willis Swanton, MD 4294 Laurel Dr, P.o. Box 578, Lake Odessa, MI 48849-9423 Ph: (616) 374-7660 | Brian Willis Swanton, MD 4294 Laurel Dr, Lake Odessa, MI 48849-9423 Ph: (616) 374-7660 |
Lee O Stuart, MD General Practice Medicare: Not Enrolled in Medicare Practice Location: 4294 Laurel Dr, Lake Odessa, MI 48849 Phone: 616-374-7660 Fax: 616-374-0270 |