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Organization
TRI-STATE UROLOGY
Active
Organization
TRI-STATE UROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK JOSEPH SWOFFORD D.O. (PRESIDENT PHYSICIAN)
(606) 437-9550
Entity
Organization
Contact information
Practice address
255 CHURCH ST, STE. 202, PIKEVILLE, KY 41501-3476
(606) 437-9550
(606) 437-9510
Mailing address
PO BOX 2438, PIKEVILLE, KY 41502-2438
(606) 437-9550
(606) 437-9510
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
02625
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245238484
—
KY
05
—
65935009
—
KY
Enumeration date
01/19/2007
Last updated
09/21/2010
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