MEDICARE: NANCY KANG DAVIS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	MD.36644	AL
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	54625	AZ
3	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	33105	OK
4	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	MD40917	SC
5	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	R2566	TX
6	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	2017-00829	NC
7	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	ME-127724	FL
8	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	78614	GA
9	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	04-40187	KS
10	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	23402	MS
11	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	2017011271	MO
12	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	MD025998	LA
13	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	MD2006822	NM
14	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	E-10454	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770621658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY KANG DAVIS MD

Provider Business Mailing Address
First Line	:	4850 NORTHSHORE LN
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72118
Country	:	US
Telephone Number	:	501-225-1400
Fax Number	:	501-225-1401

Provider Business Practice Location Address
First Line	:	4850 NORTHSHORE LN
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72118
Country	:	US
Telephone Number	:	501-225-1400
Fax Number	:	501-225-1401

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	03/09/2018

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Directions to “ NANCY KANG DAVIS MD” Practice Location

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