Provider Demographics
NPI:1245215995
Name:SWAN, LINDA T (MD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:T
Last Name:SWAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 BETHESDA DRIVE
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1880
Mailing Address - Country:US
Mailing Address - Phone:740-454-4788
Mailing Address - Fax:740-450-6157
Practice Address - Street 1:945 BETHESDA DRIVE
Practice Address - Street 2:SUITE 330
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1880
Practice Address - Country:US
Practice Address - Phone:740-454-8800
Practice Address - Fax:740-454-7707
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35057202S207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000185168OtherANTHEM PIN
OH0836813Medicaid
CA1586OtherGROUP MEDICARE RAILROAD
OH311413469037OtherCARESOURCE PIN
OH0989499OtherGROUP MEDICAID
OH000000176954OtherUNISON PIN
OH0700524OtherUHC PIN
OH160051597OtherMEDICARE RAILROAD
9270906Medicare PIN
OH0700524OtherUHC PIN
OH311413469037OtherCARESOURCE PIN