Provider Demographics
NPI:1366553349
Name:SZWARC, BRIAN J (MD)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:J
Last Name:SZWARC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:301 W. HANSELL STREET
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-6678
Mailing Address - Country:US
Mailing Address - Phone:229-226-1443
Mailing Address - Fax:229-226-3035
Practice Address - Street 1:100 MIMOSA DR
Practice Address - Street 2:3RD FLOOR
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-6676
Practice Address - Country:US
Practice Address - Phone:229-226-1443
Practice Address - Fax:229-226-3035
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044119207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00755939BMedicaid
GA04BDCJDMedicare ID - Type Unspecified
GA00755939BMedicaid