Individual
JAY A SWEDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6500 E 2ND ST, SUITE 200, CASPER, WY 82609-4338
(307) 577-5100
(307) 234-1201
Mailing address
6500 E 2ND ST, SUITE 200, CASPER, WY 82609-4338
(307) 577-5100
(307) 234-1201
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
19719
CO
207Q00000X
Family Medicine Physician
Primary
3305A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104351000
—
WY
01
—
314127
BC/BS
WY
01
—
611665900
DEPT OF LABOR
WY
Enumeration date
07/07/2005
Last updated
02/11/2008
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