Basic Information
| Provider Information | |||||||||
| NPI: | 1306223060 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SWARTZWELDER-COZAD | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | RAE | ||||||||
| NamePrefix: | |||||||||
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| Credential: | M.D. | ||||||||
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| OtherLastName: | SWARTZWELDER | ||||||||
| OtherFirstName: | ELIZABETH | ||||||||
| OtherMiddleName: | RAE | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 810 FALLS CREEK DR | ||||||||
| Address2: | # B | ||||||||
| City: | VANDALIA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 453778600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9377344141 | ||||||||
| FaxNumber: | 9372777249 | ||||||||
| Practice Location | |||||||||
| Address1: | 2261 PHILADELPHIA DRIVE | ||||||||
| Address2: | FIVE RIVERS FAMILY HEALTH CENTER | ||||||||
| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9377344141 | ||||||||
| FaxNumber: | 9372777249 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2015 | ||||||||
| LastUpdateDate: | 12/11/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 35.130580 | OH | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.