Provider Demographics
NPI:1780758698
Name:SWARTS, CAROL JOAN (MD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:JOAN
Last Name:SWARTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 SUMMER LN
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-4711
Mailing Address - Country:US
Mailing Address - Phone:513-543-1122
Mailing Address - Fax:859-578-0834
Practice Address - Street 1:127 SUMMER LN
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-4711
Practice Address - Country:US
Practice Address - Phone:513-543-1122
Practice Address - Fax:859-578-0834
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY140992085R0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A70998Medicare UPIN