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NPI Code Detail

MEDICARE: DR. CHAD JASON TERRY DO

MEDICARE: DR. CHAD JASON TERRY 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
12084P0800XPsychiatry Physician010713AZ
22084P0800XPsychiatry PhysicianDO3037NV

General Provider Information

NPI Number : 1578927679
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHAD JASON TERRY DO
Provider Business Mailing Address
First Line : 1860 N 95TH LN STE 300
Second Line :
City : PHOENIX
State : AZ
Zip : 85037-5074
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1860 N 95TH LN STE 300
Second Line :
City : PHOENIX
State : AZ
Zip : 85037-5074
Country : US
Telephone Number : 480-626-7584
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2016
Last Update Date : 05/29/2026

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