Pang, Jim
Pang, Jim is an sole proprietor health care provider with primary practice located at 65 Germantown Ct Ste 402 , Cordova TN 38018-7290. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Geriatric Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Pang, Jim can be contacted via phone (901) 752-4900.Contact Information
Primary practice address
65 Germantown Ct Ste 402
Cordova TN 38018-7290
Phone: (901) 752-4900
Fax: (901) 752-4902
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | C-5226 | Arkansas |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 14059 | Mississippi |
| Allopathic & Osteopathic Physicians / Geriatric Psychiatry | 2084P0805X | 2006031057 | Missouri |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 017659 | Tennessee |
Profile Details
| NPI number | 1780690230 |
|---|---|
| LBN Legal business name | Pang, Jim |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 1st, 2006 |
| Last updated | Feb 9th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780690230 | NPPES |
| Tennessee | Other | 0063427 | BLUE CROSS PROVIDER NUMBE |
| Tennessee | MEDICAID | 00115350 | BLUE CROSS PROVIDER NUMBE |
| Tennessee | MEDICAID | 02850722 | BLUE CROSS PROVIDER NUMBE |
| Tennessee | MEDICAID | 207980814 | BLUE CROSS PROVIDER NUMBE |
| Tennessee | MEDICAID | 3024414 | BLUE CROSS PROVIDER NUMBE |
| Tennessee | MEDICAID | 127994001 | BLUE CROSS PROVIDER NUMBE |
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