Provider Demographics
NPI:1689602260
Name:GAO, LING (MD, PHD)
Entity type:Individual
Prefix:
First Name:LING
Middle Name:
Last Name:GAO
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 W MARKHAM, SLOT 576,
Mailing Address - Street 2:UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205
Mailing Address - Country:US
Mailing Address - Phone:501-526-4861
Mailing Address - Fax:
Practice Address - Street 1:4301 W. MARKHAM, SLOT 576
Practice Address - Street 2:DEPT OF DERMATOLOGY, UNIV OF ARKANSAS FOR MED SCIENCES
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205
Practice Address - Country:US
Practice Address - Phone:501-526-4861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-6420207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR183173001Medicaid
AR5AD936884Medicare PIN