Healthcare Provider Details

I. General information

NPI: 1649267998
Provider Name (Legal Business Name): MARK W SWAIM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 PHYSICIANS DR TRANSSOUTH HEALTH CARE PC
JACKSON TN
38305
US

IV. Provider business mailing address

PO BOX 11567
JACKSON TN
38308
US

V. Phone/Fax

Practice location:
  • Phone: 731-661-0086
  • Fax: 731-661-0281
Mailing address:
  • Phone: 731-661-0086
  • Fax: 731-661-0281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number36638
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License Number36638
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: