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Individual

DOUGLAS GERALD SWANSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
455 E PIKES PEAK AVE, STE 105, COLORADO SPRINGS, CO 80903-3672
(719) 635-7288
(719) 473-6113
Mailing address
455 E PIKES PEAK AVE, STE 105, COLORADO SPRINGS, CO 80903-3672
(719) 635-7288
(719) 473-6113

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24789
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01247899
CO
01
C530248
MEDICARE ID-TYPE UNSPECIFIED
Enumeration date
04/10/2006
Last updated
03/28/2019
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