Mr. Earl Cephas Chester JR.
Dermatologist
115 S 15th Ave
Pocatello
, Idaho 83201
Mr. Earl Cephas Chester JR.
Dermatologist
115 S 15th Ave
Pocatello
, Idaho 83201
(208) 232-0432
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About
Features
Specialties
- Dermatologist
Languages spoken
- English
Location
First Address
- Mr. Earl Cephas Chester JR.
- 115 S 15th Ave
- Pocatello, ID
- Zip : 83201
- Fax : (208) 232-0432
- Phone : (208) 232-2106
Second Address
- Mr. Earl Cephas Chester JR.
- 115 S 15th Ave
- Pocatello, ID
- Zip : 83201
- Fax : (208) 232-0432
- Phone : (208) 232-2106
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Is Mr. Earl Cephas Chester JR. a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207N00000X | Dermatologist | M3346 | ID |
National Provider Identifier
| NPI | 1053469668 |
|---|---|
| Provider Name | Mr. Earl Cephas Chester JR. |
| First Address | Pocatello, ID 83201 |
| Second Address | Pocatello, ID 83201 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/01/2007 |
| Last Update Date | 17/04/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1110276 | MEDICARE PROVIDER (01) | ID |
| D73450 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.