Provider Demographics
NPI:1831168384
Name:SWENSON, JON HALLIE (MD)
Entity type:Individual
Prefix:
First Name:JON
Middle Name:HALLIE
Last Name:SWENSON
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:JON
Other - Middle Name:
Other - Last Name:SWENSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:730 THIMBLE SHOALS BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4562
Mailing Address - Country:US
Mailing Address - Phone:757-873-1554
Mailing Address - Fax:757-873-3239
Practice Address - Street 1:730 THIMBLE SHOALS BLVD STE 130
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4562
Practice Address - Country:US
Practice Address - Phone:757-873-1554
Practice Address - Fax:757-873-3239
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101046095207XS0106X, 207XS0114X, 207XX0004X, 207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA294503OtherSOUTHERN HEALTH SERVICES
VA541869550OtherVHN
VA336140OtherMAMSI
VA64-0566-5Medicaid
VA65725560-2OtherPHCS
VA392354OtherBLUE CROSS BLUE SHIELD
VA541869550OtherTRICARE
VA541869550OtherMULTIPLAN
VA55051OtherSENTARA HMO/PPO
VA021325OtherCIGNA
VA4355119OtherAETNA
VA3899680001Medicare NSC
VA021325OtherCIGNA
VA65725560-2OtherPHCS