MEDICARE: JON HALLIE SWENSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician	0101046095	VA
2	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	0101046095	VA
3	207X00000X	Orthopaedic Surgery Physician	0101046095	VA

General Provider Information

NPI Number	:	1831168384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JON HALLIE SWENSON MD

Provider Business Mailing Address
First Line	:	730 THIMBLE SHOALS BLVD STE 130
Second Line	:
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23606-4562
Country	:	US
Telephone Number	:	757-873-1554
Fax Number	:	757-873-3239

Provider Business Practice Location Address
First Line	:	730 THIMBLE SHOALS BLVD STE 130
Second Line	:
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23606-4562
Country	:	US
Telephone Number	:	757-873-1554
Fax Number	:	757-873-3239

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	02/16/2026

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