Healthcare Provider Details

I. General information

NPI: 1780758698
Provider Name (Legal Business Name): CAROL JOAN SWARTS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 SUMMER LN
CRESTVIEW HILLS KY
41017-4711
US

IV. Provider business mailing address

127 SUMMER LN
CRESTVIEW HILLS KY
41017-4711
US

V. Phone/Fax

Practice location:
  • Phone: 513-543-1122
  • Fax: 859-578-0834
Mailing address:
  • Phone: 513-543-1122
  • Fax: 859-578-0834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License Number14099
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: