Individual
SHOU - JIANG TANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-4540
Mailing address
2500 N STATE ST, DIVISION OF GASTROENTEROLOGY, JACKSON, MS 39216-4500
(601) 984-4540
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
21274
MS
207RG0100X
Gastroenterology Physician
L9924
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01239701
—
MS
05
—
123695
—
AL
05
—
167962301
—
TX
05
—
2142267
—
LA
01
—
302I103478
MEDICARE PTAN
MS
Enumeration date
04/28/2006
Last updated
08/12/2014
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