Provider Demographics
NPI:1154691814
Name:MCSWAIN WILLIAMSON PLLC
Entity type:Organization
Organization Name:MCSWAIN WILLIAMSON PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-442-0111
Mailing Address - Street 1:2225 E FLAMINGO RD
Mailing Address - Street 2:STE 105
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5125
Mailing Address - Country:US
Mailing Address - Phone:702-419-7529
Mailing Address - Fax:702-538-8151
Practice Address - Street 1:2225 E FLAMINGO RD
Practice Address - Street 2:STE 105
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5125
Practice Address - Country:US
Practice Address - Phone:702-419-7529
Practice Address - Fax:702-538-8151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVDO1502208D00000X
NVDW009333208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty