Individual
DR. JIM PANG JR.
Active
Individual
DR. JIM PANG JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
017659
TN
2084P0800X
Psychiatry Physician
14059
MS
2084P0800X
Psychiatry Physician
C-5226
AR
2084P0805X
Geriatric Psychiatry Physician
2006031057
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115350
—
MS
01
—
0063427
BLUE CROSS PROVIDER NUMBE
TN
05
—
02850722
—
MS
05
—
127994001
—
AR
05
—
207980814
—
MO
05
—
3024414
—
TN
Enumeration date
08/01/2006
Last updated
02/09/2020
Update your record
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