Healthcare Provider Details

I. General information

NPI: 1528028206
Provider Name (Legal Business Name): JAMES A SWARTZ PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

806 S OTSEGO AVE
GAYLORD MI
49735-1725
US

IV. Provider business mailing address

9251 JOHNSON RD
MANCELONA MI
49659-9693
US

V. Phone/Fax

Practice location:
  • Phone: 989-732-6555
  • Fax: 989-732-6577
Mailing address:
  • Phone: 231-587-5421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601003195
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: