Individual
DR. DAN CONG PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4301 W MARKHAM ST # 517, LITTLE ROCK, AR 72205-7101
(501) 686-8000
(501) 526-5148
Mailing address
4301 W MARKHAM ST # 783, LITTLE ROCK, AR 72205-7101
(501) 686-8000
(501) 526-5148
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
49316
TN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
58530
AZ
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
A105477
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
E-8164
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689899601
—
CA
01
—
DN065S
MEDICARE PTAN-AUBURN
CA
01
—
DN065T
MEDICARE PTAN-DAVIS
CA
01
—
DN065U
MEDICARE PTAN-ROSEVILLE
CA
01
—
DN065X
MEDICARE PTAN-MERCY
CA
01
—
DN065Y
MEDICARE PTAN-METH
CA
01
—
DN065Z
MEDICARE PTAN-DPMG
CA
01
—
GN065V
MEDICARE PTAN-MEM
CA
01
—
GN065W
MEDICARE PTAN-GEN
CA
Enumeration date
04/16/2007
Last updated
07/03/2025
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