Provider Demographics
NPI:1639735822
Name:HEALD, JON THOMAS (DO)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:THOMAS
Last Name:HEALD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4954 N PALMER RD BLDG 19
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-5630
Mailing Address - Country:US
Mailing Address - Phone:301-319-2100
Mailing Address - Fax:301-319-2119
Practice Address - Street 1:4954 N PALMER RD BLDG 19
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-5630
Practice Address - Country:US
Practice Address - Phone:301-319-2100
Practice Address - Fax:301-319-2119
Is Sole Proprietor?:No
Enumeration Date:2019-05-14
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020041194207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine