Individual
PHILLIP JAMES SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15813 PAUL VEGA MD DR STE 401A, HAMMOND, LA 70403-1426
(985) 230-1580
(985) 230-1585
Mailing address
39715 S HOOVER RD APT A, PONCHATOULA, LA 70454-4651
(662) 848-9597
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
237082
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
237082
LICENSE
LA
Enumeration date
08/13/2024
Last updated
10/17/2024
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