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NPI Code Detail

MEDICARE: AUDREY M SWANK PA-C

MEDICARE: AUDREY M SWANK PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant50.004824RXOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PENDINGOTHEROHANTHEM BCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093257867
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUDREY M SWANK PA-C
Provider Business Mailing Address
First Line : 550 TRUMBULL AVE
Second Line :
City : CORTLAND
State : OH
Zip : 44410-9403
Country : US
Telephone Number : 330-637-2000
Fax Number : 330-637-2001
Provider Business Practice Location Address
First Line : 550 TRUMBULL AVE
Second Line :
City : CORTLAND
State : OH
Zip : 44410-9403
Country : US
Telephone Number : 330-637-2000
Fax Number : 330-637-2001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2016
Last Update Date : 11/10/2016

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Directions to “ AUDREY M SWANK PA-C” Practice Location

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