Provider Demographics
NPI:1588652275
Name:CHAN, PATRICK DOOR-SHANG (MD)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:DOOR-SHANG
Last Name:CHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-7319
Mailing Address - Country:US
Mailing Address - Phone:501-305-4577
Mailing Address - Fax:501-305-3466
Practice Address - Street 1:1120 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-7319
Practice Address - Country:US
Practice Address - Phone:501-305-4577
Practice Address - Fax:501-305-3466
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE2551207T00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Not Answered207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5L481Medicare ID - Type Unspecified
H21779Medicare UPIN