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General NPI Number Information
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NPI Number | 1366936056
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Entity Type | Individual
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Provider Name | JORDAN EDWARD SWISHER DO
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Gender | Male
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Dates
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Enumeration Date | 06/18/2018
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Last Update Date | 07/01/2024
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Provider Practice Location Address
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Address Line | 2900 W OAKLAHOMA AVE.
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City | MILWAUKEE
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State | WI
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Zip | 53215
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Country | US
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Telephone | 414-550-6961
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Fax | 313-343-8747
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Provider Business Mailing Address
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Address Line | 2900 W OAKLAHOMA AVE.
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City | MILWAUKEE
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State | WI
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Zip | 53215
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Country | US
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Telephone | 414-550-6961
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Fax | 313-343-8747
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 5101024176
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 8144121
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License Number State | WI
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