Provider Demographics
NPI:1306859475
Name:SWAGLER, CURTIS P (DO)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:P
Last Name:SWAGLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:CURTIS
Other - Middle Name:P
Other - Last Name:SWAGLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:EISENHOWER DRIVE
Mailing Address - Street 2:RM 422 STUDENT HEALTH CENTER
Mailing Address - City:UNIVERSITY PARK
Mailing Address - State:PA
Mailing Address - Zip Code:16802
Mailing Address - Country:US
Mailing Address - Phone:814-863-6747
Mailing Address - Fax:814-863-8464
Practice Address - Street 1:EISENHOWER DRIVE
Practice Address - Street 2:RM 422 STUDENT HEALTH CENTER
Practice Address - City:UNIVERSITY PARK
Practice Address - State:PA
Practice Address - Zip Code:16802
Practice Address - Country:US
Practice Address - Phone:814-863-6747
Practice Address - Fax:814-863-8464
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-004172L208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000745495Medicaid
B36232Medicare UPIN
095814FEMMedicare ID - Type Unspecified