Basic Information
| Provider Information | |||||||||
| NPI: | 1598767998 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SWAIN | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | TAU | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 S 8TH ST | ||||||||
| Address2: | SUITE 401E | ||||||||
| City: | MURRAY | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420712400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707532444 | ||||||||
| FaxNumber: | 2707673644 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 S 8TH ST | ||||||||
| Address2: | SUITE 401E | ||||||||
| City: | MURRAY | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420712400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707532444 | ||||||||
| FaxNumber: | 2707673644 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2005 | ||||||||
| LastUpdateDate: | 07/20/2007 | ||||||||
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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 | 208600000X | 37663 | KY | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 4063914 | 01 | TN | TN BC/BS PIN # | OTHER | 5955989 | 01 | KY | CIGNA PIN # | OTHER | 611330797001 | 01 | KY | TRICARE GRP # | OTHER | 64062623 | 05 | KY | MEDICAID | 65933855 | 05 | KY | MEDICAID | 000000290295 | 01 | KY | BC/BS PIN # | OTHER | CB3611 | 01 | KY | RR MEDICARE GRP # | OTHER | P00001579 | 01 | KY | RR MEDICARE PIN # | OTHER | 1801902341 | 01 | KY | GROUP NPI | OTHER |