| Doctor Name: | RANDALL W CHANG |
| NPI Number: | 1033208889 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 001820 |
| Business Practice Address: | 1340 Broad Ave Suite 420 Gulfport, MS - 395012404 |
| Business Phone Number: | 2285751500 |
| Business Fax Number: | |
| Mailing Address: | 1340 Broad Ave, Suite 420 GULFPORT |
| State: | MS |
| Postal Code: | 395012404 |
| Phone Number: | 2285751500 |
| Fax Number: | |
| NPI Enumeration Date: | 10/12/2006 |
| NPI Last Update Date: | 10/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 001820 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |