Healthcare Provider Details

I. General information

NPI: 1396747242
Provider Name (Legal Business Name): WILLIAM B. SWALLOW DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 12/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 HEDGEAPPLE DRIVE
BELLEVILLE PA
17004
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-4903
US

V. Phone/Fax

Practice location:
  • Phone: 717-667-9030
  • Fax: 717-667-9165
Mailing address:
  • Phone: 570-271-6144
  • Fax: 570-271-6578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS004410L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: