Provider Demographics
NPI:1396729513
Name:SWIFT, CAROL S (MD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:S
Last Name:SWIFT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:LYNN
Other - Last Name:SMOTHERS-SWIFT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-765-5727
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:18989 OLD SCENIC HWY
Practice Address - Street 2:
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-8105
Practice Address - Country:US
Practice Address - Phone:225-765-5500
Practice Address - Fax:225-306-4456
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA021925207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1670880Medicaid
LAP00408729OtherRAILROAD MEDICARE
LA1670880Medicaid
LA5W613DX80Medicare PIN