Provider Demographics
NPI:1871591198
Name:HERNANDEZ, JON DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:DAVID
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 MACK BLVD FL 4
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-5622
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:
Practice Address - Street 1:2226 BLAKESLEE BOULEVARD DR E STE 200
Practice Address - Street 2:
Practice Address - City:LEHIGHTON
Practice Address - State:PA
Practice Address - Zip Code:18235-9619
Practice Address - Country:US
Practice Address - Phone:610-408-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD424128207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1010825780001Medicaid
2170525OtherMAMSI
2454072OtherUNITED HEALTHCARE
90334OtherGEISINGER HEALTH PLAN
P00144458OtherRAILROAD MEDICARE
P3253696OtherOXFORD HEALTH PLANS
1614028OtherHIGHMARK BLUE SHIELD
0651358OtherCIGNA HEALTHCARE
2291153000OtherINDEPENDENCE BLUE CROSS
2291153000OtherAMERIHEALTH
328962OtherHEALTH AMERICA/HEALTH ASS
50044348OtherCAPITAL BLUE CROSS
50044348OtherKEYSTONE HEALTH CENTRAL
819317OtherFIRST PRIORITY HEALTH
9336898OtherPRIVATE HEALTHCARE SYSTEM
2291153000OtherKEYSTONE HEALTH EAST
556421OtherAETNA PPO
2291153000OtherAMERIHEALTH
90334OtherGEISINGER HEALTH PLAN