Provider Demographics
NPI:1528063815
Name:SWAFFORD, ALBERT R (MD)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:R
Last Name:SWAFFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21539
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93390-1539
Mailing Address - Country:US
Mailing Address - Phone:661-829-4201
Mailing Address - Fax:661-368-1624
Practice Address - Street 1:300 OLD RIVER RD
Practice Address - Street 2:#150
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-9503
Practice Address - Country:US
Practice Address - Phone:661-663-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2015-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC37020207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C370201Medicare PIN
CA00C370200Medicare PIN
CAA36453Medicare UPIN
00C370200Medicare ID - Type Unspecified