Organization
STANLEY J. CHESLOCK, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STANLEY J CHESLOCK M.D. (OWNER, PRESIDENT)
(208) 529-6430
Entity
Organization
Contact information
Practice address
2860 CHANNING WAY, SUITE 224, IDAHO FALLS, ID 83404-7531
(208) 529-6430
(208) 529-6428
Mailing address
2860 CHANNING WAY, SUITE 224, IDAHO FALLS, ID 83404-7531
(208) 529-6430
(208) 529-6428
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M3570
ID
Other
Enumeration date
01/17/2008
Last updated
01/17/2008
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