Provider Demographics
NPI:1992891048
Name:SWAGERTY, DANIEL L JR (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:L
Last Name:SWAGERTY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45324-2640
Mailing Address - Country:US
Mailing Address - Phone:937-245-7200
Mailing Address - Fax:937-245-7999
Practice Address - Street 1:954 SEDGEFIELD CT
Practice Address - Street 2:
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039-7513
Practice Address - Country:US
Practice Address - Phone:513-275-6551
Practice Address - Fax:513-880-0849
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.130348207QG0300X
KS04-214812083P0500X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
080082423OtherRAILROAD MEDICARE
OH0225441Medicaid
080082423OtherRAILROAD MEDICARE
080082423OtherRAILROAD MEDICARE
KS624901OtherFIRSTGUARD
MO208634006Medicaid
080082423OtherRAILROAD MEDICARE