Healthcare Provider Details

I. General information

NPI: 1639580707
Provider Name (Legal Business Name): JIAN CHEN M.D.,PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2014
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1146 S. CEDAR CREST BLVD 2ND FLOOR
ALLENTOWN PA
18103-7938
US

IV. Provider business mailing address

4802 E JOHNSON AVE
JONESBORO AR
72405-8413
US

V. Phone/Fax

Practice location:
  • Phone: 610-366-9000
  • Fax: 610-366-9229
Mailing address:
  • Phone: 870-936-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number905-L
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number87218
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number2025034484
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: