# MAGNOLIA FAMILY MEDICINE, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598212185
- **Authorized official:** DR. JASON BRYCE SWALM D.O. (SOLE MEMBER)
- **Authorized official phone:** (304) 267-6249

## Contact information

- **Practice address:** 3 CERITOS TRAIL, MARTINSBURG, WV 25403-0300
- **Practice address phone:** (304) 267-6249
- **Practice address fax:** (304) 267-6248
- **Mailing address:** 3 CERITOS TRAIL, MARTINSBURG, WV 25403-0300
- **Mailing address phone:** (304) 267-6249
- **Mailing address fax:** (304) 267-6248

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 2952 | WV | Yes |

## Other

- **Enumeration date:** 09/01/2016
- **Last updated:** 11/14/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1962745950 | — | WV |