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Individual
JIMMY C CHANG
Active
Individual
JIMMY C CHANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
C5948
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111261001
—
AR
01
—
11257000000
QUALCHOICE
—
01
—
160021272
RAILROAD MEDICARE
AR
01
—
242061
HEALTHLINK
AR
Enumeration date
07/12/2005
Last updated
08/10/2010
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