Individual
LAWRENCE C. SWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2620 WESTSIDE DR NW, CLEVELAND, TN 37312-3605
(423) 339-1760
(423) 559-1483
Mailing address
2620 WESTSIDE DR NW, CLEVELAND, TN 37312-3605
(423) 339-1760
(423) 559-1483
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
018699
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0078692
BCBS TN
TN
01
—
1584771
GHI
TN
01
—
3032152
MEDICARE - INDIVIDUAL
TN
05
—
3032152
—
TN
01
—
320350
BCBS GA
GA
01
—
3719860
MEDICARE - GROUP
TN
01
—
A99578
MEDICARE UPIN
TN
01
—
TN0101
UHC RIVER VALLEY / JDHC
TN
Enumeration date
05/11/2006
Last updated
01/21/2008
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