Individual
JACK D SCHWINGHAMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
331 HIGHWAY 65 S, MORA, MN 55051-1899
(320) 679-1313
(320) 225-3141
Mailing address
PO BOX 43, MR 10809, MINNEAPOLIS, MN 55440-0043
(612) 262-4813
(612) 262-4194
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
33011
IA
207Q00000X
Family Medicine Physician
Primary
42746
MN
207Q00000X
Family Medicine Physician
RL-0256
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
762698300
—
MN
Enumeration date
04/06/2006
Last updated
04/24/2014
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