Provider Demographics
NPI:1588755110
Name:SWAYMAN, KENNETH CRAIG (DPM)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:CRAIG
Last Name:SWAYMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2741 DEBARR RD STE C315
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2992
Mailing Address - Country:US
Mailing Address - Phone:907-562-4958
Mailing Address - Fax:907-562-5195
Practice Address - Street 1:2741 DEBARR RD STE C315
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2992
Practice Address - Country:US
Practice Address - Phone:907-562-4958
Practice Address - Fax:907-562-5195
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAK3393213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKOOWCNJXEMedicare ID - Type UnspecifiedMEDICARE
AKU35194Medicare UPIN