Provider Demographics
NPI:1730316480
Name:SWAGGERTY, ELIZABETH ELLIOTT (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ELLIOTT
Last Name:SWAGGERTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:CATHERINE
Other - Last Name:ELLIOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11100 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1716
Mailing Address - Country:US
Mailing Address - Phone:216-844-8299
Mailing Address - Fax:
Practice Address - Street 1:1300 E 23RD ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-5701
Practice Address - Country:US
Practice Address - Phone:423-760-4000
Practice Address - Fax:423-760-4051
Is Sole Proprietor?:No
Enumeration Date:2009-06-19
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.099339207Q00000X
TN64325207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN64325OtherMEDICAL LICENSE NUMER