Provider Demographics
NPI:1073306676
Name:YEN, VICTOR CHIN JON
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:CHIN JON
Last Name:YEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5316 HIALEAH DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-4605
Mailing Address - Country:US
Mailing Address - Phone:601-708-3004
Mailing Address - Fax:
Practice Address - Street 1:5316 HIALEAH DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-4605
Practice Address - Country:US
Practice Address - Phone:601-708-3004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program