Provider Demographics
NPI:1881076198
Name:SWAB, JOHN (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:SWAB
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2861 NE INDEPENDENCE AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-2379
Mailing Address - Country:US
Mailing Address - Phone:816-525-2840
Mailing Address - Fax:
Practice Address - Street 1:6301 N LUCERNE AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64151-3105
Practice Address - Country:US
Practice Address - Phone:816-525-2840
Practice Address - Fax:816-525-2841
Is Sole Proprietor?:No
Enumeration Date:2015-06-23
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A18135207X00000X
MO2021014909207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery