Provider Demographics
NPI:1386937803
Name:LIN, TIFFANY CHEN-I (MD)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:CHEN-I
Last Name:LIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1685 HIGHLAND AVE
Mailing Address - Street 2:4126 MFCB
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-2281
Mailing Address - Country:US
Mailing Address - Phone:214-886-2703
Mailing Address - Fax:
Practice Address - Street 1:1685 HIGHLAND AVE
Practice Address - Street 2:4126 MFCB
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-2281
Practice Address - Country:US
Practice Address - Phone:214-886-2703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-17
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI65527-20207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology