1033176458 NPI number — HAROLD MICHAEL MCSWAIN M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033176458 NPI number — HAROLD MICHAEL MCSWAIN M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

MCSWAIN

Provider First Name:

HAROLD

Provider Middle Name:

MICHAEL

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1033176458

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

07/08/2007

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

1325 WOLF PARK DR

Provider Second Line Business Mailing Address:

SUITE 103

Provider Business Mailing Address City Name:

GERMANTOWN

Provider Business Mailing Address State Name:

TN

Provider Business Mailing Address Postal Code:

38138-1742

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

901-252-3411

Provider Business Mailing Address Fax Number:

901-384-6422

Provider First Line Business Practice Location Address:

1325 WOLF PARK DR

Provider Second Line Business Practice Location Address:

SUITE 102

Provider Business Practice Location Address City Name:

GERMANTOWN

Provider Business Practice Location Address State Name:

TN

Provider Business Practice Location Address Postal Code:

38138-1742

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

901-252-3400

Provider Business Practice Location Address Fax Number:

901-682-0047

Provider Enumeration Date:

04/28/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 208800000X , with the licence number:  10752 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
• Taxonomy code: 208800000X , with the licence number: 11629 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

• Identifier: 2110025200 . This is a "QUAL CHOICE" identifier . This identifiers is of the category "OTHER".
• Identifier: 96831 . This is a "BLUE CROSS AR" identifier . This identifiers is of the category "OTHER".
• Identifier: FIRST HEALTH . This is a "730667" identifier . This identifiers is of the category "OTHER".
• Identifier: 12940250 . This is a "PHCS" identifier . This identifiers is of the category "OTHER".
• Identifier: 337662 . This is a "HEALTH LINK" identifier . This identifiers is of the category "OTHER".
• Identifier: 4843342 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
• Identifier: 38709 . This is a "TLC TENNCARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 0067092 . This is a "BLUE CROSS" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
• Identifier: 12940250 . This is a "HEALTH ASSURANCE EPA" identifier . This identifiers is of the category "OTHER".
• Identifier: 211159 . This is a "SOUTHERN HEALTH SERVICES" identifier . This identifiers is of the category "OTHER".
• Identifier: 3196252 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
• Identifier: 4664770 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".