Individual
TIMOTHY CHIN-YU CHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 BAPTIST DR, SUITE 104, MADISON, MS 39110-2009
(601) 605-2383
Mailing address
965 RIDGE LAKE BLVD STE 103, MEMPHIS, TN 38120-9446
(901) 227-3255
(901) 227-8591
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22583
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164441
RESIDENT TRAINING LICENSE
NC
01
—
22583
LICENSE NUMBER
MS
Enumeration date
04/21/2010
Last updated
03/07/2023
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