Provider Demographics
NPI:1144285396
Name:SWANTON, ROBERT G (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:G
Last Name:SWANTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:1120 ROBERT BLVD SUITE 100
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2939
Mailing Address - Country:US
Mailing Address - Phone:985-280-8688
Mailing Address - Fax:985-280-6642
Practice Address - Street 1:1120 ROBERT BLVD SUITE 100
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458
Practice Address - Country:US
Practice Address - Phone:985-280-8688
Practice Address - Fax:985-280-6642
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA0221482085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1555185Medicaid
LAG77242Medicare UPIN
LA1555185Medicaid