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General NPI Number Information
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NPI Number | 1326085655
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Entity Type | Individual
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Provider Name | GARY SWANSON MD
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Gender | Male
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 01/07/2008
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Provider Practice Location Address
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Address Line | 1080 N ELLINGTON PKWY
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City | LEWISBURG
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State | TN
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Zip | 37091-2227
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Country | US
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Telephone | 904-805-1300
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Fax | 904-805-1302
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Provider Business Mailing Address
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Address Line | PO BOX 532734
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City | ATLANTA
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State | GA
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Zip | 30353-2734
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Country | US
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Telephone | 904-805-1300
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Fax | 904-805-1302
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD011234
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License Number State | TN
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