Healthcare Provider Details

I. General information

NPI: 1982189122
Provider Name (Legal Business Name): JOHN-MATTHEW SWORDS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2018
Last Update Date: 09/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 DOCTORS LN STE 202
CLARION PA
16214-8574
US

IV. Provider business mailing address

3071 S GRAND AVE
CARTHAGE MO
64836-7851
US

V. Phone/Fax

Practice location:
  • Phone: 814-226-2500
  • Fax: 814-226-2501
Mailing address:
  • Phone: 417-310-9286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2018034280
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOT019168
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: