Provider Demographics
NPI:1922387299
Name:CHENYI, CHENYI JEFFREY (MD)
Entity Type:Individual
Prefix:
First Name:CHENYI
Middle Name:JEFFREY
Last Name:CHENYI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15225 HIGHWAY 43
Mailing Address - Street 2:SUITE 1
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35653-1999
Mailing Address - Country:US
Mailing Address - Phone:256-311-2700
Mailing Address - Fax:256-311-2777
Practice Address - Street 1:15225 HIGHWAY 43
Practice Address - Street 2:SUITE 1
Practice Address - City:RUSSELLVILLE
Practice Address - State:AL
Practice Address - Zip Code:35653-1999
Practice Address - Country:US
Practice Address - Phone:256-311-2700
Practice Address - Fax:256-311-2777
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301098925207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine