Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 08640 | MS |
NPI | 1033166756 |
---|---|
Provider Name | Dr. Ching Jygh Chen |
First Address | Jackson, MS 39216-4500 |
Second Address | Jackson, MS 39216-4651 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2006 |
Last Update Date | 22/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00017570 | (05) | MS |
148583 | (05) | AL |
180039522 | RAILROAD MEDICARE (01) | MS |
6010530001 | DMERC (01) | MS |
D00963 | (02) | MS |
P00462169 | RAILROAD MEDICARE (01) | MS |