# JIMMY C CHANG

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1285632463
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | C5948 | AR | Yes |

## Other

- **Enumeration date:** 07/12/2005
- **Last updated:** 08/10/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 111261001 | — | AR |
| 01 | — | 11257000000 | QUALCHOICE | — |
| 01 | — | 160021272 | RAILROAD MEDICARE | AR |
| 01 | — | 242061 | HEALTHLINK | AR |