Individual
JULIA D SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1500 SALEM ST, LAFAYETTE, IN 47904-2164
(765) 448-8000
(765) 448-8337
Mailing address
PO BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000
(765) 448-8085
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01055782A
IN
207Q00000X
Family Medicine Physician
32798
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000636188
ANTHEM PROVIDER NUMBER
IN
05
—
200423590
—
IN
01
—
37298
MEDICAL LICENSE
IA
Enumeration date
03/27/2006
Last updated
12/09/2011
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