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General NPI Number Information
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NPI Number | 1497775688
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Entity Type | Individual
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Provider Name | CHARLIE L SWANSON JR. MD
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Gender | Male
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 12/11/2020
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Provider Practice Location Address
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Address Line | 2900 TYLER RD
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City | CHRISTIANSBURG
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State | VA
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Zip | 24073-6374
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Country | US
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Telephone | 540-731-7314
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Fax | 540-731-7377
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Provider Business Mailing Address
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Address Line | 2900 TYLER RD
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City | CHRISTIANSBURG
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State | VA
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Zip | 24073-6374
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Country | US
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Telephone | 540-731-7314
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Fax | 540-731-7377
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 24718
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2084P0800X
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License Number State | VA
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