Provider Demographics
NPI:1548085616
Name:JONES, CHASIDY (CPT)
Entity type:Individual
Prefix:
First Name:CHASIDY
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:679 E 127TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44108-2441
Mailing Address - Country:US
Mailing Address - Phone:216-399-6910
Mailing Address - Fax:
Practice Address - Street 1:2313 LEE RD STE 337
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-3427
Practice Address - Country:US
Practice Address - Phone:216-243-1311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH14-03-2041T207ZH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology