Dr Jeremy Robert Chidester, MD | |
1309 W South Jordan Pkwy Ste 110, South Jordan, UT 84095-9014 | |
(801) 839-5557 | |
(801) 770-4455 |
Full Name | Dr Jeremy Robert Chidester |
---|---|
Gender | Male |
Speciality | Plastic Surgery |
Location | 1309 W South Jordan Pkwy Ste 110, South Jordan, Utah |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1194015693 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2082S0105X | Plastic Surgery - Surgery Of The Hand | 10668647-1205 (Utah) | Secondary |
208200000X | Plastic Surgery | 10668647-1205 (Utah) | Primary |
Entity Name | Ihc Health Services Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1629260880 PECOS PAC ID: 1850209420 Enrollment ID: O20031105000079 |
Entity Name | Ward Md Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1114378023 PECOS PAC ID: 4082976360 Enrollment ID: O20180326002904 |
Entity Name | Plastics Clinic Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1184318826 PECOS PAC ID: 7517315096 Enrollment ID: O20231121003131 |
Mailing Address | Practice Location Address |
---|---|
Dr Jeremy Robert Chidester, MD 1309 W South Jordan Pkwy Ste 110, South Jordan, UT 84095-9014 Ph: (801) 839-5557 | Dr Jeremy Robert Chidester, MD 1309 W South Jordan Pkwy Ste 110, South Jordan, UT 84095-9014 Ph: (801) 839-5557 |
Makayla Nelson, Plastic Surgery Medicare: Not Enrolled in Medicare Practice Location: 5126 W Daybreak Pkwy, South Jordan, UT 84009 Phone: 801-213-5200 | |
Rylee Faye Woodward, LME Plastic Surgery Medicare: Not Enrolled in Medicare Practice Location: 5126 W Daybreak Pkwy, South Jordan, UT 84009 Phone: 801-213-4500 | |
Dr. Bryan Vern Sonntag, MD Plastic Surgery Medicare: Not Enrolled in Medicare Practice Location: 10437 S Jordan Gtwy, South Jordan, UT 84095 Phone: 801-571-7710 Fax: 801-571-7738 |