Individual
BRIAN R. SWENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1965 S FREMONT AVE, SUITE 100, SPRINGFIELD, MO 65804-2201
(417) 820-3800
(417) 820-3810
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2011012611
MO
208C00000X
Colon & Rectal Surgery Physician
Primary
2011012611
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922116086
—
MO
05
—
207498001
—
AR
01
—
P01095875
RR MEDICARE
MO
Enumeration date
08/28/2006
Last updated
11/19/2015
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