Organization
ORTHOPAEDIC TRAUMA CONSULTANTS OF IDAHO
Active
Other names
North Fork Orthopedic Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE DYLAN CHLEBECK MD (OWNER)
(208) 595-4440
Entity
Organization
Contact information
Practice address
875 S VANGUARD WAY STE 110, MERIDIAN, ID 83642-8541
(208) 595-4440
(855) 592-2514
Mailing address
875 S VANGUARD WAY STE 110, MERIDIAN, ID 83642-8541
(208) 595-4440
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
03/12/2024
Last updated
04/09/2024
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