| Dr Keith Robert Swanson, MD | |
|
212 Elks Point Rd, Ste 200, Zephyr Cove, NV 89448-8001 | |
| (775) 589-8950 | |
| (775) 588-1299 |
| Full Name | Dr Keith Robert Swanson |
|---|---|
| Gender | Male |
| Speciality | Orthopaedic Surgery - Sports Medicine |
| Location | 212 Elks Point Rd, Zephyr Cove, Nevada |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255330312 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207XX0005X | Orthopaedic Surgery - Sports Medicine | 4005 (Nevada) | Primary |
| 207XX0005X | Orthopaedic Surgery - Sports Medicine | C34400 (California) | Secondary |
| Entity Name | Lake Tahoe Orthopaedic Institute A Watson-swanson Professional Corp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609937911 PECOS PAC ID: 3375448384 Enrollment ID: O20031203000511 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Keith Robert Swanson, MD 1111 Emerald Bay Rd, South Lake Tahoe, CA 96150-6207 Ph: (530) 543-5659 | Dr Keith Robert Swanson, MD 212 Elks Point Rd, Ste 200, Zephyr Cove, NV 89448-8001 Ph: (775) 589-8950 |
Dr. Randy Charles Watson, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 212 Elks Point Road, Suite 200, Zephyr Cove, NV 89448 Phone: 775-588-3636 Fax: 775-588-1299 | |
Dr. Jonathan Taylor Hagen, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 212 Elks Point Rd Ste 200, Zephyr Cove, NV 89448 Phone: 775-589-8950 Fax: 775-588-1299 |