Provider Demographics
NPI:1134211576
Name:CHASE, JEFFREY M (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:M
Last Name:CHASE
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:PO BOX 8360
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00801
Mailing Address - Country:US
Mailing Address - Phone:340-714-2845
Mailing Address - Fax:
Practice Address - Street 1:9149 ESTATE THOMAS
Practice Address - Street 2:PARAGON MEDICAL BUILDING STE 104
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-2615
Practice Address - Country:US
Practice Address - Phone:340-714-2845
Practice Address - Fax:340-714-2843
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL136163207XX0005X
VI1122207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI4364590001Medicare NSC
VIH75671Medicare UPIN