Healthcare Provider Details

I. General information

NPI: 1881076198
Provider Name (Legal Business Name): JOHN SWAB D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2015
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6301 N LUCERNE AVE
KANSAS CITY MO
64151-3105
US

IV. Provider business mailing address

2861 NE INDEPENDENCE AVE STE 201
LEES SUMMIT MO
64064-2379
US

V. Phone/Fax

Practice location:
  • Phone: 816-525-2840
  • Fax: 816-525-2841
Mailing address:
  • Phone: 816-525-2840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number05-48109
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number20A18135
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number2021014909
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: