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General NPI Number Information
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NPI Number | 1407153539
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Entity Type | Organization
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Legal Business Name | JAMES L. SWINGLER M.D. GYNECOLOGY & OBSTETRICS S.C.
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Dates
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Enumeration Date | 02/25/2011
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Last Update Date | 02/25/2011
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Provider Practice Location Address
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Address Line | 7501 N UNIVERSITY ST SUITE 113
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City | PEORIA
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State | IL
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Zip | 61614-1222
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Country | US
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Telephone | 309-692-0128
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Fax | 309-692-0193
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Provider Business Mailing Address
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Address Line | 7501 N UNIVERSITY ST SUITE 113
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City | PEORIA
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State | IL
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Zip | 61614-1222
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Country | US
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Telephone | 309-692-0128
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Fax | 309-692-0193
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES LEE SWINGLER
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Credential | M.D.
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Telephone | 309-692-0128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036062855
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License Number State | IL
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