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Organization

LAWRENCE C. SWAN, M.D.

Active
Other names
Covenant Family Medicine
Organization subpart
No

Provider details

NPI number
Authorized official
LAWRENCE CARL SWAN M.D. (OWNER)
(423) 339-1760
Entity
Organization

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0078692
BCBST GROUP
TN
01
1584771
GHI - SWAN
TN
01
1584772
GHI - SIMS
TN
01
245331943
TRICARE - SIMS INDIVIDUAL
TN
01
272525633
TRICARE - SWAN INDIVIDUAL
TN
01
3032152
MEDICARE IND- SWAN
TN
01
3719860
MEDICARE GROUP
TN
01
3880829
MEDICAID - SIMS
TN
01
4052544
BCBST IND - SIMS
TN
01
44D0309375
CLIA - GROUP
TN
01
A99578
UPIN - SWAN
TN
01
G62659
UPIN - SIMS
TN
Enumeration date
10/18/2006
Last updated
12/01/2015
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