Healthcare Provider Details
I. General information
NPI: 1053090191
Provider Name (Legal Business Name): VIRGINIA SCHORR SWINEHART
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/17/2023
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6262 VETERANS PKWY
COLUMBUS GA
31909-3540
US
IV. Provider business mailing address
PO BOX 370
FORTSON GA
31808-0370
US
V. Phone/Fax
- Phone: 706-324-6661
- Fax:
- Phone: 706-494-3171
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363AS0400X |
| Taxonomy | Surgical Physician Assistant |
| License Number | PA.2463 |
| License Number State | AL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AS0400X |
| Taxonomy | Surgical Physician Assistant |
| License Number | 12603 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: