Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Qing Ivy Fan, MD

Individual provider Internal Medicine Physician · NPI 1679520365

Qing Ivy Fan, MD is an Internal Medicine Physician in Jacksonville, Florida. Licensed in Tennessee. Registered with an NPI since 2006.

Licensed in
TN
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

6817 Southpoint Pkwy #503
Jacksonville, FL 32216-6282
Phone: (904) 296-9777
Fax: (904) 296-9977
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 0000040237 (TN)

Record details

NPI number1679520365
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 28, 2006
Last updated in NPPESSeptember 18, 2008

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