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Individual

MR. JEFFREY SCOTT SWENSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1308 8TH ST STE 1, RUPERT, ID 83350
(208) 436-4322
(208) 436-1312
Mailing address
1224 8TH STREET, RUPERT, ID 83350-1532
(208) 434-8236
(208) 436-1312

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M9766
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
78193
BLX
ID
05
M0027582
ID
05
M8073867
ID
Enumeration date
10/06/2005
Last updated
06/05/2025
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