Individual
JESSE DYLAN CHLEBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
875 S VANGUARD WAY, MERIDIAN, ID 83642-8540
(208) 463-3000
Mailing address
875 S VANGUARD WAY STE 110, MERIDIAN, ID 83642-8541
(208) 595-4440
(855) 592-2514
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
A148489
CA
207X00000X
Orthopaedic Surgery Physician
Primary
M-14245
ID
207XX0801X
Orthopaedic Trauma Physician
A148489
CA
207XX0801X
Orthopaedic Trauma Physician
M-14245
ID
Other
Enumeration date
04/03/2012
Last updated
04/09/2024
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