Provider Demographics
NPI:1639580707
Name:CHEN, JIAN (MD,PHD)
Entity Type:Individual
Prefix:
First Name:JIAN
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4802 E JOHNSON AVE
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72405-8413
Mailing Address - Country:US
Mailing Address - Phone:870-936-8000
Mailing Address - Fax:
Practice Address - Street 1:1146 S. CEDAR CREST BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-7938
Practice Address - Country:US
Practice Address - Phone:610-366-9000
Practice Address - Fax:610-366-9229
Is Sole Proprietor?:No
Enumeration Date:2014-05-12
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC87218208VP0014X
390200000X
MS905-L2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program