Provider Demographics
NPI:1538377791
Name:JING, XI LIN (MD)
Entity type:Individual
Prefix:DR
First Name:XI LIN
Middle Name:
Last Name:JING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1068 CRESTHAVEN RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-0800
Mailing Address - Country:US
Mailing Address - Phone:901-866-8525
Mailing Address - Fax:901-302-2525
Practice Address - Street 1:3401 N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-5103
Practice Address - Country:US
Practice Address - Phone:215-707-3933
Practice Address - Fax:215-707-2531
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD 54232208200000X
PAMD447118208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03054279Medicaid
TNQ024671Medicaid
GA003182131AMedicaid
MO1538377791Medicaid
AR220206001Medicaid