Provider Demographics
NPI:1134355225
Name:CHAFFIN, PHILLIP LEE JR (MD)
Entity type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:LEE
Last Name:CHAFFIN
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1055 N 300 W
Mailing Address - Street 2:STE 401
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-3306
Mailing Address - Country:US
Mailing Address - Phone:801-357-7499
Mailing Address - Fax:801-373-5980
Practice Address - Street 1:1055 N 300 W
Practice Address - Street 2:STE 401
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-3306
Practice Address - Country:US
Practice Address - Phone:801-357-7499
Practice Address - Fax:801-373-5980
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2015-07-13
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Provider Licenses
StateLicense IDTaxonomies
UT9348982-1205207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology