Individual
DR. JIM PANG JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
65 GERMANTOWN CT STE 402, CORDOVA, TN 38018-7290
(901) 752-4900
(901) 752-4902
Mailing address
65 GERMANTOWN CT STE 402, CORDOVA, TN 38018-7290
(901) 752-4900
(901) 752-4902
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
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