Provider Demographics
NPI:1992296461
Name:SWARTZ, JESSA L (MD)
Entity type:Individual
Prefix:
First Name:JESSA
Middle Name:L
Last Name:SWARTZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8485 W BLUEBIRD RD
Mailing Address - Street 2:
Mailing Address - City:LAKE TOMAHAWK
Mailing Address - State:WI
Mailing Address - Zip Code:54539-9431
Mailing Address - Country:US
Mailing Address - Phone:715-892-4942
Mailing Address - Fax:
Practice Address - Street 1:1881 COUNTY ROAD XX
Practice Address - Street 2:
Practice Address - City:KRONENWETTER
Practice Address - State:WI
Practice Address - Zip Code:54455-7933
Practice Address - Country:US
Practice Address - Phone:715-355-4040
Practice Address - Fax:715-359-8461
Is Sole Proprietor?:No
Enumeration Date:2018-05-21
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI72690-20207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine