Organization
MILLPORT FAM PRACTICE CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT E SWANSON DNP, CRNP (MANAGING PARTNER)
(205) 662-5784
Entity
Organization
Contact information
Practice address
13530 HIGHWAY 96, MILLPORT, AL 35576-2522
(205) 662-5784
(205) 662-5786
Mailing address
13530 HIGHWAY 96, MILLPORT, AL 35576-2522
(205) 662-5784
(205) 662-5786
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
541003936
—
AL
Enumeration date
03/05/2007
Last updated
05/28/2015
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