Basic Information
| Provider Information | |||||||||
| NPI: | 1023101938 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SWEAT | ||||||||
| FirstName: | GREGORY | ||||||||
| MiddleName: | T | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7301 E FRONTAGE RD | ||||||||
| Address2: | |||||||||
| City: | MERRIAM | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662041632 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9137891940 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7301 E FRONTAGE RD | ||||||||
| Address2: | |||||||||
| City: | MERRIAM | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662041632 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9137891940 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2006 | ||||||||
| LastUpdateDate: | 04/29/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 04-30307 | IA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 17282051 | 01 | KS | BLUE CROSS | OTHER |