Healthcare Provider Details

I. General information

NPI: 1922997477
Provider Name (Legal Business Name): COLONNADE SURGICAL PARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2025
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3980 COLONNADE PKWY STE 100
BIRMINGHAM AL
35243-2382
US

IV. Provider business mailing address

PO BOX 59449
BIRMINGHAM AL
35259-9449
US

V. Phone/Fax

Practice location:
  • Phone: 205-876-8967
  • Fax: 205-564-0538
Mailing address:
  • Phone: 205-876-8967
  • Fax: 205-564-0538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JASON SWANNER
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 205-317-0009