Healthcare Provider Details

I. General information

NPI: 1982094181
Provider Name (Legal Business Name): GEOFFREY ALLEN SWIGER CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2015
Last Update Date: 01/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 MORNINGSIDE DR
SHELBY OH
44875-1624
US

IV. Provider business mailing address

10 MORNINGSIDE DR
SHELBY OH
44875-1624
US

V. Phone/Fax

Practice location:
  • Phone: 419-989-1443
  • Fax:
Mailing address:
  • Phone: 419-989-1443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCOA17031
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: