MEDICARE: MARK A SWISHER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	24436	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0037676	OTHER	KY	MEDICARE - FAYETTE COUNTY HEALTH DEPARTMENT
7	110136243	OTHER	KY	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	611012421P	OTHER	KY	HUMANA HMO
3	000000047818	OTHER	KY	ANTHEM BC/BS
4	0400544	OTHER	KY	UNITED HEALTHCARE
5	1404232	OTHER	KY	UMWA
6	0400360	OTHER	KY	UNITED HEALTHCARE
8	1284109	OTHER	KY	UMWA
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558365528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK A SWISHER MD

Provider Business Mailing Address
First Line	:	1221 S BROADWAY
Second Line	:	SB-5
City	:	LEXINGTON
State	:	KY
Zip	:	40504-2701
Country	:	US
Telephone Number	:	859-258-4530
Fax Number	:	859-258-4870

Provider Business Practice Location Address
First Line	:	1221 S BROADWAY
Second Line	:	SB-5
City	:	LEXINGTON
State	:	KY
Zip	:	40504-2701
Country	:	US
Telephone Number	:	859-258-4530
Fax Number	:	859-258-4870

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	01/09/2012

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Directions to “ MARK A SWISHER MD” Practice Location

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