Swelstad, Jack A
Swelstad, Jack A is an individual health care provider with primary practice located at 2845 Greenbrier Rd Ste 230 , Green Bay WI 54311-6519. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Swelstad, Jack A can be contacted via phone (920) 288-8250.Contact Information
Primary practice address
2845 Greenbrier Rd Ste 230
Green Bay WI 54311-6519
Phone: (920) 288-8250
Fax: (920) 288-8255
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 21530 | Wisconsin |
Profile Details
| NPI number | 1972524601 |
|---|---|
| LBN Legal business name | Swelstad, Jack A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 21st, 2006 |
| Last updated | Sep 30th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972524601 | NPPES |
| Wisconsin | MEDICAID | 03218700 |
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