Provider Demographics
NPI:1407169535
Name:CHESNEY, JASON DAVID (DO)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:DAVID
Last Name:CHESNEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 ABBOT RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-1956
Mailing Address - Country:US
Mailing Address - Phone:517-332-0100
Mailing Address - Fax:517-332-0356
Practice Address - Street 1:1500 ABBOT RD
Practice Address - Street 2:SUITE 400
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-1956
Practice Address - Country:US
Practice Address - Phone:517-332-0100
Practice Address - Fax:517-332-0356
Is Sole Proprietor?:No
Enumeration Date:2010-07-18
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101018631207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery