Provider Demographics
NPI:1285757690
Name:SWIFT, JEAN ANN (JEAN SWIFT, DO)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:ANN
Last Name:SWIFT
Suffix:
Gender:F
Credentials:JEAN SWIFT, DO
Other - Prefix:DR
Other - First Name:JEAN
Other - Middle Name:ANN
Other - Last Name:SWIFT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:JEAN SWIFT, DO
Mailing Address - Street 1:65-1267 KAWAIHAE RD
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-8406
Mailing Address - Country:US
Mailing Address - Phone:808-887-6668
Mailing Address - Fax:808-887-6668
Practice Address - Street 1:65-1267 KAWAIHAE RD
Practice Address - Street 2:
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8406
Practice Address - Country:US
Practice Address - Phone:808-887-6668
Practice Address - Fax:808-887-6668
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDOS806207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH54259Medicare ID - Type UnspecifiedMEDICARE ID NUMBER