Provider Demographics
NPI:1942311584
Name:SWISHER IV, JOHN T (DO, CAQ, FAAFP)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:SWISHER IV
Suffix:
Gender:M
Credentials:DO, CAQ, FAAFP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 S ILLINOIS AVE
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-5405
Mailing Address - Country:US
Mailing Address - Phone:641-428-3041
Mailing Address - Fax:
Practice Address - Street 1:910 N EISENHOWER AVE
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-1552
Practice Address - Country:US
Practice Address - Phone:641-428-5911
Practice Address - Fax:641-428-5985
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD8418207QS0010X
IA03815207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine