Jerry Chidester MD Pllc

NPI #1558983775 in Draper, Utah

Provider Information

NPI Number: 1558983775
Entity Type: Organization
Organization Name: Jerry Chidester MD Pllc
Primary Specialty: Clinic/Center
Enumeration Date: May 11, 2020
Last Updated: May 11, 2020

Practice Location

Address: 11762 S STATE ST STE 333
City: Draper
State: Utah
ZIP Code: 84020-7166
Phone: (801) 839-5557

Authorized Official

Name: JEREMY ROBERT CHIDESTER, MD
Title: PLASTIC SURGEON
Phone: (801) 839-5557

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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