Healthcare Provider Details

I. General information

NPI: 1801876826
Provider Name (Legal Business Name): PAUL ALLEN SCHWIGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DR. PAUL ALLEN SCHWIGER JR.

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 TAMARACK AVE STE 104
SOUTH WINDSOR CT
06074-5553
US

IV. Provider business mailing address

PO BOX 686
ATHENS TN
37371-0686
US

V. Phone/Fax

Practice location:
  • Phone: 860-533-4695
  • Fax: 860-648-0013
Mailing address:
  • Phone: 423-368-2171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD10210
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberC1-0026667
License Number StateDE
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number62163
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: