Healthcare Provider Details

I. General information

NPI: 1366735102
Provider Name (Legal Business Name): JASON SWABY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2011
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 WHITE SULPHUR RD STE 120
GAINESVILLE GA
30501-2569
US

IV. Provider business mailing address

750 E ADAMS ST
SYRACUSE NY
13210-2342
US

V. Phone/Fax

Practice location:
  • Phone: 770-219-0963
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number272052
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number78727
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: