Basic Information
| Provider Information | |||||||||
| NPI: | 1588983241 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SWAGLER | ||||||||
| FirstName: | KARL ANDREW | ||||||||
| MiddleName: | MORRISON | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4401 PENN AVE | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152241334 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126925180 | ||||||||
| FaxNumber: | 4126927355 | ||||||||
| Practice Location | |||||||||
| Address1: | 4401 PENN AVE | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152241334 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126925180 | ||||||||
| FaxNumber: | 4126927355 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2010 | ||||||||
| LastUpdateDate: | 05/09/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | 10002566A | IN | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | MA060630 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
ID Information
| ID | Type | State | Issuer | Description | MA060630 | 01 | PA | PENNSYLVANIA BOARD OF MEDICINE, PHYSICIAN ASSISTANT LICENSE | OTHER | 5846 | 01 | GA | GEORGIA COMPOSITE MEDICAL BOARD, PHYSICIAN ASSISTANT LICENSE | OTHER | 10002566A | 01 | IN | INDIANA PROFESSIONAL LICENSING AGENCY, PHYSICIAN ASSISTANT LICENSE | OTHER | 10002566B | 01 | IN | INDIANA PROFESSIONAL LICENSING AGENCY, CSR-PHYSICIAN ASSISTANT LICENSE | OTHER | 1087880 | 01 | NCCPA | OTHER | MS2731873 | 01 | DEA | OTHER |