Individual
KEVIN ROY SWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
214 SOUTHCITY PKWY STE 101, LAFAYETTE, LA 70503-5718
(337) 981-6430
(337) 981-9134
Mailing address
214 SOUTHCITY PKWY STE 101, LAFAYETTE, LA 70503-5718
(337) 981-6430
(337) 981-9134
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
136354
NC
207W00000X
Ophthalmology Physician
Primary
MD.203713
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1215112578
BLUE CROSS BLUE SHIELD
LA
Enumeration date
01/07/2008
Last updated
08/24/2022
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