| 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 |
| Certification Date | 05/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558983775 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
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