Healthcare Provider Details

I. General information

NPI: 1710055223
Provider Name (Legal Business Name): HANES MCPHERSON SWINGLE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 02/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 CENTER ST STE 1S
MOBILE AL
36604-1512
US

IV. Provider business mailing address

PO BOX 40480
MOBILE AL
36640-0480
US

V. Phone/Fax

Practice location:
  • Phone: 251-410-5437
  • Fax: 251-434-3852
Mailing address:
  • Phone: 251-410-5437
  • Fax: 251-434-3852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35108
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number35108
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number28081
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: