Healthcare Provider Details

I. General information

NPI: 1467415620
Provider Name (Legal Business Name): RALPH L CHESTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

463 S LAKE POWELL BLVD
PAGE AZ
86040-0856
US

IV. Provider business mailing address

1932 ARLINGTON BLVD STE 121
CHARLOTTESVILLE VA
22903-1560
US

V. Phone/Fax

Practice location:
  • Phone: 928-645-5113
  • Fax:
Mailing address:
  • Phone: 434-956-9175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number67784
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number088
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number67784
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101238996
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: