Provider Demographics
NPI:1164604096
Name:CHRIS SWAYZE M D PLLC
Entity Type:Organization
Organization Name:CHRIS SWAYZE M D PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:REED
Authorized Official - Last Name:SWAYZE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-367-8232
Mailing Address - Street 1:PO BOX 1343
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40588-1343
Mailing Address - Country:US
Mailing Address - Phone:888-850-6310
Mailing Address - Fax:
Practice Address - Street 1:1760 NICHOLASVILLE RD
Practice Address - Street 2:SUITE 301
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1471
Practice Address - Country:US
Practice Address - Phone:888-850-6310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY29101207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64291016Medicaid