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Organization
INDIANA INTERVENTIONAL PAIN, LLC
Active
Organization
INDIANA INTERVENTIONAL PAIN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN B SWOFFORD D.O. (PRESIDENT-OWNER)
(317) 567-2180
Entity
Organization
Contact information
Practice address
5445 E 16TH ST, INDIANAPOLIS, IN 46218-4869
(317) 355-4358
(317) 567-2191
Mailing address
PO BOX 3056, INDIANAPOLIS, IN 46206-3056
(317) 567-2180
(317) 567-2191
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
IN
208VP0000X
Pain Medicine Physician
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000373172
ANTHEM
IN
05
—
200530430
—
IN
01
—
DE7729
RAILROAD MEDICARE
IN
Enumeration date
06/15/2006
Last updated
11/25/2009
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