Healthcare Provider Details

I. General information

NPI: 1033473392
Provider Name (Legal Business Name): JOHN WILLIAM SCHWEITZER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2012
Last Update Date: 01/25/2024
Certification Date: 01/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 N STATE OF FRANKLIN RD GROUND FLOOR
JOHNSON CITY TN
37604-6056
US

IV. Provider business mailing address

PO BOX 699
MOUNTAIN HOME TN
37684-0699
US

V. Phone/Fax

Practice location:
  • Phone: 423-439-7320
  • Fax:
Mailing address:
  • Phone: 423-433-6039
  • Fax: 423-433-6060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number48734
License Number StateTN

VII. Legacy identifiers

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

# 1
Identifier1033473392
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer
# 2
Identifier1033473392
Identifier TypeMEDICAID
Identifier StateVA
Identifier Issuer
# 3
Identifier1528857
Identifier TypeMEDICAID
Identifier StateTN
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: