Provider Demographics
NPI:1528028206
Name:SWARTZ, JAMES A (PA-C)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:SWARTZ
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9251 JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:MANCELONA
Mailing Address - State:MI
Mailing Address - Zip Code:49659-9693
Mailing Address - Country:US
Mailing Address - Phone:231-587-5421
Mailing Address - Fax:
Practice Address - Street 1:806 S OTSEGO AVE
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-1725
Practice Address - Country:US
Practice Address - Phone:989-732-6555
Practice Address - Fax:989-732-6577
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601003195363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIVAD000Medicare ID - Type UnspecifiedVA ID NUMBER