Provider Demographics
NPI:1770621658
Name:DAVIS, NANCY KANG (MD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:KANG
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:JIN HEE
Other - Last Name:KANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4850 NORTHSHORE LN
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72118
Mailing Address - Country:US
Mailing Address - Phone:501-225-1400
Mailing Address - Fax:501-225-1401
Practice Address - Street 1:4850 NORTHSHORE LN
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72118
Practice Address - Country:US
Practice Address - Phone:501-225-1400
Practice Address - Fax:501-225-1401
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.36644207ZP0102X
AZ54625207ZP0102X
OK33105207ZP0102X
SCMD40917207ZP0102X
TXR2566207ZP0102X
NC2017-00829207ZP0102X
FLME-127724207ZP0102X
GA78614207ZP0102X
KS04-40187207ZP0102X
MS23402207ZP0102X
MO2017011271207ZP0102X
LAMD025998207ZP0102X
NMMD2006822207ZP0102X
ARE-10454207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS04729021Medicaid
LA1055468Medicaid
MS04729021Medicaid
LA1055468Medicaid