Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 5101018631 | MI |
NPI | 1407169535 |
---|---|
Provider Name | Dr. Jason David Chesney |
First Address | East Lansing, MI 48823-1956 |
Second Address | East Lansing, MI 48823-1956 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2010 |
Last Update Date | 27/06/2016 |