Individual
DR. EVAN JOEL SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1301 S. MAIN ST., OTTAWA, KS 66067
(785) 229-8300
(785) 229-8417
Mailing address
PO BOX 460, OTTAWA, KS 66067-0460
(785) 229-8284
(785) 229-3377
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0428397
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100397980A
—
KS
05
—
100397980B
—
KS
Enumeration date
05/24/2005
Last updated
06/19/2012
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