Healthcare Provider Details

I. General information

NPI: 1821071846
Provider Name (Legal Business Name): DR. WILLIAM J. SWARTWORTH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: WILLIAM J. SWARTWORTH SR. MD

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 01/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1327 TROUP HWY
TYLER TX
75701-4443
US

IV. Provider business mailing address

512 CONTENDERS WAY
TYLER TX
75703-0804
US

V. Phone/Fax

Practice location:
  • Phone: 903-581-4300
  • Fax:
Mailing address:
  • Phone: 903-581-4300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number13201
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: