Provider Demographics
NPI:1275750325
Name:CHENEY, JASON ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:ANDREW
Last Name:CHENEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 N. LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:KS
Mailing Address - Zip Code:67420-0587
Mailing Address - Country:US
Mailing Address - Phone:785-738-2246
Mailing Address - Fax:785-738-4303
Practice Address - Street 1:1005 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:KS
Practice Address - Zip Code:67420-1215
Practice Address - Country:US
Practice Address - Phone:785-738-2246
Practice Address - Fax:785-738-4303
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0432241207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine