Doctor Name: | TRAVIS JAY SWIFT |
NPI Number: | 1053691238 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | 0010-03061 |
Business Practice Address: | 10494 W Thunderbird Blvd Suite 102 Sun City, AZ - 853513058 |
Business Phone Number: | 6235375600 |
Business Fax Number: | 8669392673 |
Mailing Address: | 18444 N 25th Ave, Suite 310 PHOENIX |
State: | AZ |
Postal Code: | 850231261 |
Phone Number: | 6235375600 |
Fax Number: | 8669392673 |
NPI Enumeration Date: | 08/19/2011 |
NPI Last Update Date: | 01/20/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | 0010-03061 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |