MEDICARE: DR. JON D HOUSEWORTH DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	PR301	FL
2	213ES0103X	Foot & Ankle Surgery Podiatrist	0109901269	VA

General Provider Information

NPI Number	:	1932456001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JON D HOUSEWORTH DPM

Provider Business Mailing Address
First Line	:	6512 WOODLAKE VILLAGE CIR
Second Line	:
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23112-2200
Country	:	US
Telephone Number	:	833-448-3261
Fax Number	:

Provider Business Practice Location Address
First Line	:	6512 WOODLAKE VILLAGE CIR
Second Line	:
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23112-2200
Country	:	US
Telephone Number	:	833-448-3261
Fax Number	:

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

Provider Enumeration Date	:	08/08/2012
Last Update Date	:	04/01/2025

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