Provider Demographics
NPI:1063442572
Name:SWARTZ, JOHN F III (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:SWARTZ
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3810
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64803
Mailing Address - Country:US
Mailing Address - Phone:417-347-5000
Mailing Address - Fax:417-347-6454
Practice Address - Street 1:1102 W 32ND STREET
Practice Address - Street 2:STE 300
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804
Practice Address - Country:US
Practice Address - Phone:417-347-5000
Practice Address - Fax:417-347-6454
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006005295207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100302970BMedicaid
MO200746006Medicaid
MO206431OtherANTHEM
P00309842OtherRR MEDICARE
OK100026170AMedicaid
D74766Medicare UPIN
MO200746006Medicaid