MEDICARE: WILLIE J CHESTER DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	DO138	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235106543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIE J CHESTER DO

Provider Business Mailing Address
First Line	:	4452 US HIGHWAY 231
Second Line	:
City	:	WETUMPKA
State	:	AL
Zip	:	36092-3328
Country	:	US
Telephone Number	:	334-420-5038
Fax Number	:	334-420-0158

Provider Business Practice Location Address
First Line	:	4452 US HIGHWAY 231
Second Line	:
City	:	WETUMPKA
State	:	AL
Zip	:	36092-3328
Country	:	US
Telephone Number	:	334-420-5001
Fax Number	:	334-293-6640

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2006
Last Update Date	:	08/01/2016

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Directions to “ WILLIE J CHESTER DO” Practice Location

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