MEDICARE: CHENYI JEFFREY CHENYI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	4301098925	MI

General Provider Information

NPI Number	:	1922387299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHENYI JEFFREY CHENYI MD

Provider Business Mailing Address
First Line	:	15225 HIGHWAY 43
Second Line	:	SUITE 1
City	:	RUSSELLVILLE
State	:	AL
Zip	:	35653-1999
Country	:	US
Telephone Number	:	256-311-2700
Fax Number	:	256-311-2777

Provider Business Practice Location Address
First Line	:	15225 HIGHWAY 43
Second Line	:	SUITE 1
City	:	RUSSELLVILLE
State	:	AL
Zip	:	35653-1999
Country	:	US
Telephone Number	:	256-311-2700
Fax Number	:	256-311-2777

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2011
Last Update Date	:	01/06/2017

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