Provider Demographics
NPI:1487640934
Name:SCHWENINGER, JOHN KEVIN (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:KEVIN
Last Name:SCHWENINGER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 HUGHES RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-3000
Mailing Address - Country:US
Mailing Address - Phone:256-319-0115
Mailing Address - Fax:
Practice Address - Street 1:34 HUGHES RD
Practice Address - Street 2:SUITE B
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-3000
Practice Address - Country:US
Practice Address - Phone:256-319-0115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO1144207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2465853OtherAETNA
FL80060OtherBLUE CROSS/BLUE SHIELD
AL51107204OtherBLUE CROSS BLUE SHIELD OF AL
FL80060OtherBLUE CROSS/BLUE SHIELD
FL2465853OtherAETNA
FL3944300001Medicare NSC