| Jay A Swedberg, | |
|
6500 E 2nd St, Suite 200, Casper, WY 82609-4338 | |
| (307) 577-5100 | |
| (307) 234-1201 |
| Full Name | Jay A Swedberg |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 6500 E 2nd St, Casper, Wyoming |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467450163 | NPI | - | NPPES |
| 104351000 | Medicaid | WY | |
| 314127 | Other | WY | BC/BS |
| 611665900 | Other | WY | DEPT OF LABOR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 3305A (Wyoming) | Primary |
| 207Q00000X | Family Medicine | 19719 (Colorado) | Secondary |
| Entity Name | University Of Wyoming |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770681439 PECOS PAC ID: 4183607054 Enrollment ID: O20040610001637 |
| Entity Name | Life Care Physician Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770807919 PECOS PAC ID: 5395861306 Enrollment ID: O20120424000585 |
| Mailing Address | Practice Location Address |
|---|---|
| Jay A Swedberg, 6500 E 2nd St, Suite 200, Casper, WY 82609-4338 Ph: (307) 577-5100 | Jay A Swedberg, 6500 E 2nd St, Suite 200, Casper, WY 82609-4338 Ph: (307) 577-5100 |
Savannah Marie Cardenas, FNP, DNP Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 6500 E 2nd St, Casper, WY 82609 Phone: 307-577-5100 | |
Zachory Fred Deiss, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1522 E A St, Casper, WY 82601 Phone: 307-234-6161 | |
Philip Gard, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1522 E A St, Casper, WY 82601 Phone: 307-234-6161 | |
Dr. Johnny M Tooke, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2241 Farnum Ste 105, Casper, WY 82609 Phone: 307-266-1263 Fax: 307-265-0410 | |
Larissa Faith Gray, PA-C Family Medicine Medicare: Medicare Enrolled Practice Location: 1522 E A St, Casper, WY 82601 Phone: 307-234-6161 | |
Adam Linck, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1020 S. Conwell Street, Casper, WY 82601 Phone: 307-265-8300 Fax: 307-233-8230 | |
Renae Marie Hepfner, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 1522 E A St, Casper, WY 82601 Phone: 307-234-6161 |