Individual
DR. WILLIAM RUSSELL SWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
513 SE 13TH CT, PRYOR, OK 74361-7625
(918) 864-0470
Mailing address
513 SE 13TH CT, PRYOR, OK 74361-7625
(918) 864-0470
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
9895
OK
207R00000X
Internal Medicine Physician
9895
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
J7309811339
—
OK
Enumeration date
07/18/2007
Last updated
06/21/2015
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