Individual
KYLE I SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2801 W KINNICKINNIC RIVER PKWY STE 630, MILWAUKEE, WI 53215
(414) 385-7111
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
53817-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100032100
—
WI
05
—
123104
—
AZ
Enumeration date
07/18/2008
Last updated
07/02/2024
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