Provider Demographics
NPI:1487946042
Name:SWANSON, RANDEL LYNN II (DO, PHD)
Entity type:Individual
Prefix:DR
First Name:RANDEL
Middle Name:LYNN
Last Name:SWANSON
Suffix:II
Gender:M
Credentials:DO, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 LOMBARD ST FL 1
Mailing Address - Street 2:PENN MEDICINE RITTENHOUSE, DEPT OF PHYSICAL MED & REHAB
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1414
Mailing Address - Country:US
Mailing Address - Phone:215-893-2600
Mailing Address - Fax:215-893-2686
Practice Address - Street 1:1800 LOMBARD ST FL 1
Practice Address - Street 2:PENN MEDICINE RITTENHOUSE, DEPT OF PHYSICAL MED & REHAB
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-1414
Practice Address - Country:US
Practice Address - Phone:215-893-2600
Practice Address - Fax:215-893-2686
Is Sole Proprietor?:No
Enumeration Date:2011-05-13
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS017055208100000X
NJ25MB09357000208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation