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Contact Information

JIM PANG JR, MD
65 GERMANTOWN CT STE 402
CORDOVA, TN38018-7290
 Phone: 901-752-4900
 Fax: 901-752-4902
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for JIM PANG JR · (Male)

NPI # 1780690230
Status Active
Credentials MD
Entity Individual
Enumeration date 08/01/2006
Last updated 02/09/2020 - About 6 years ago
Sole proprietor 1 Yes
Identifiers
  • AR License # C-5226
  • MO License # 2006031057
  • MS License # 14059
  • TN License # 017659
  • AR Medicaid 127994001
  • MO Medicaid 207980814
  • MS Medicaid 00115350
  • MS Medicaid 02850722
  • TN Medicaid 3024414
  • TN Other 0063427 BLUE CROSS PROVIDER NUMBE
Hospital affiliation(s)
  • MAGNOLIA REGIONAL HEALTH CENTER - (Acute Care)
    611 ALCORN DRIVE
    CORINTH, MS 38834
  • ST FRANCIS HOSPITAL - (Acute Care)
    5959 PARK AVE
    MEMPHIS, TN 38119
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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