Provider Demographics
NPI:1992982631
Name:SWORDS, WILLIAM J (DO)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:SWORDS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 S PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-3488
Mailing Address - Country:US
Mailing Address - Phone:517-975-3750
Mailing Address - Fax:
Practice Address - Street 1:2727 S PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-3488
Practice Address - Country:US
Practice Address - Phone:517-975-3750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI510005753207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0004054845OtherAETNA US HEALTH
MI5331872OtherBLUE CROSS BLUE SHIELD OF
MIP59167OtherBLUE CARE NETWORK
MI5331872OtherBLUE CROSS BLUE SHIELD OF
MIP59167OtherBLUE CARE NETWORK