Provider Demographics
NPI:1952437345
Name:CHIN, VICTOR ALLEN (MD)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:ALLEN
Last Name:CHIN
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 1:18 RIVERBEND DR SW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-6013
Mailing Address - Country:US
Mailing Address - Phone:706-314-1900
Mailing Address - Fax:706-314-1901
Practice Address - Street 1:4715 WHITESBURG DR SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-1632
Practice Address - Country:US
Practice Address - Phone:256-881-5151
Practice Address - Fax:256-880-3939
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA063179207LP2900X, 208VP0014X
ALMD.37964207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I096188Medicare PIN