Dr P O Swanson OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1734 Issued in IA

Legal business name

DR P O SWANSON OD PC

Practice address

333 Church
Ottumwa, IA 52501

Phone

(641) 684-4695

Fax

(641) 684-7201

NPI assigned

Dec 5, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Robert Lee Blew, OD

Title

Pres

Phone

(641) 684-4695

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243296000000",
    "number": "1720146277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 CHURCH",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "52501",
            "telephone_number": "641-684-4695",
            "fax_number": "641-684-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 CHURCH",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "52501",
            "telephone_number": "641-684-4695",
            "fax_number": "641-684-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR P O SWANSON OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2009-05-26",
        "status": "A",
        "authorized_official_last_name": "BLEW",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "641-684-4695",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IA",
            "license": "1734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0212365",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Ottumwa, IA
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.