Organization
PHYLLIS CHANG, M.D., PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHYLLIS CHANG M.D. (MEMBER)
(319) 358-8788
Entity
Organization
Contact information
Practice address
604 5TH ST, CORALVILLE, IA 52241-2304
(319) 358-8788
(319) 351-9278
Mailing address
604 5TH ST, PO BOX 5036, CORALVILLE, IA 52241-2304
(319) 358-8788
(319) 351-9278
Taxonomy
Speciality
Code
Description
License number
State
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
Primary
26997
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0450049
—
IA
Enumeration date
11/28/2006
Last updated
08/22/2020
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