Provider Demographics
NPI:1447285317
Name:CHIN, FRANK T (MD)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:T
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:PO BOX 17143
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38187-0143
Mailing Address - Country:US
Mailing Address - Phone:901-377-9352
Mailing Address - Fax:
Practice Address - Street 1:2600 POPLAR AVE STE 310
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38112-3835
Practice Address - Country:US
Practice Address - Phone:901-308-8734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD11638207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4106273OtherBCBS TN
TN3047342Medicaid
P00206651OtherRR MEDICARE
TN3047342Medicare ID - Type UnspecifiedMEDICARE INDIVIDUAL
P00206651OtherRR MEDICARE