Healthcare Provider Details

I. General information

NPI: 1902428576
Provider Name (Legal Business Name): JOSEPH ROBERT SVOBODA JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2020
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9702 GAYTON RD STE 108
HENRICO VA
23238-4907
US

IV. Provider business mailing address

95 MEDICAL PARK BLVD
PETERSBURG VA
23805-9280
US

V. Phone/Fax

Practice location:
  • Phone: 804-404-6160
  • Fax:
Mailing address:
  • Phone: 804-504-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License Number0116034587
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License Number1902428576
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: