Provider Demographics
NPI:1427214543
Name:CHESLEY, JASON MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:MICHAEL
Last Name:CHESLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6900 E CAMELBACK RD
Mailing Address - Street 2:SUITE 700
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-2431
Mailing Address - Country:US
Mailing Address - Phone:602-651-1943
Mailing Address - Fax:602-302-5779
Practice Address - Street 1:6900 E CAMELBACK RD
Practice Address - Street 2:SUITE 700
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-2431
Practice Address - Country:US
Practice Address - Phone:602-651-1943
Practice Address - Fax:602-302-5779
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ44349174400000X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ644769Medicaid
AZZ153694Medicare PIN