Provider Demographics
NPI:1518057579
Name:SWANSON, JOHN STEWART (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:STEWART
Last Name:SWANSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:772 N EAST ST
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-1764
Mailing Address - Country:US
Mailing Address - Phone:413-253-5333
Mailing Address - Fax:
Practice Address - Street 1:1 PRINCE STREET
Practice Address - Street 2:MASSACHUSETTS DEPARTMENT OF MENTAL HEALTH
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01061-0389
Practice Address - Country:US
Practice Address - Phone:413-587-6294
Practice Address - Fax:413-587-6217
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA1561452084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry