Jerry Chidester Md Pllc | |
11762 S State St Ste 333 Draper UT 84020-7166 | |
(801) 839-5557 | |
Not Available |
Full Name | Jerry Chidester Md Pllc |
---|---|
Speciality | Clinic/center |
Location | 11762 S State St Ste 333, Draper, Utah |
Authorized Official Name and Position | Jeremy Robert Chidester (PLASTIC SURGEON) |
Authorized Official Contact | 8018395557 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Jerry Chidester Md Pllc 11762 S State St Ste 333 Draper UT 84020-7166 Ph: (801) 839-5557 | Jerry Chidester Md Pllc 11762 S State St Ste 333 Draper UT 84020-7166 Ph: (801) 839-5557 |
NPI Number | 1558983775 |
---|---|
Provider Enumeration Date | 05/11/2020 |
Last Update Date | 05/11/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558983775 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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