RANDALL W CHANG


Address: 1340 Broad Ave, Suite 420, Gulfport, MS 39501-2404
Phone: 2285751500

RANDALL W CHANG (NPI# 1033208889) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1033208889
Entity Type Individual
Full Name RANDALL W CHANG
Credential PA-C
Practice Address 1340 Broad Ave
Suite 420
Gulfport
MS 39501-2404
Practice Telephone 2285751500
Mailing Telephone 2285751500
Enumeration Date 2006-10-12
Last Update Date 2015-10-05
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
PA00150 MS Physician Assistants & Advanced Practice Nursing Providers
N 363AS0400X Physician Assistant
Specialization: Surgical Technologist
001820 IA Physician Assistants & Advanced Practice Nursing Providers

Other Providers RANDALL CHANG

NPI Name Taxonomy Address Enumeration
1427171578 Randall Bung Choy Chang Dentist 23 S Vineyard Blvd, #203, Honolulu, HI 96813 2007-04-06
1205961372 Randall Eric Chang Dentist 3050 Citrus Cir, Suite 110, Walnut Creek, CA 94598-2698 2007-02-22

Office Location

Street Address 1340 BROAD AVE
SUITE 420
City GULFPORT
State MS
Zip Code 39501-2404

Providers in the same location

NPI Name Taxonomy Address Enumeration
1912904590 Jesse Pullen Penico Internal Medicine 1340 Broad Ave, Suite 300, Gulfport, MS 39501-2404 2005-06-28
1306409040 Lissa Kelly Baber Nurse Practitioner 1340 Broad Ave, Gulfport, MS 39501-2404 2019-04-18
1780191577 Tbd Acquisition II LLC Social Worker 1340 Broad Ave, Gulfport, MS 39501-2404 2018-01-03
1629517115 Delana Mooney Nurse Practitioner 1340 Broad Ave, Suite 450, Gulfport, MS 39501-2404 2017-02-16
1396299590 Charles Strange Nurse Practitioner 1340 Broad Ave, Suite 450, Gulfport, MS 39501-2404 2016-08-05
1942699988 Beth Ann Gruzinskas Nurse Practitioner 1340 Broad Ave, Suite 270, Gulfport, MS 39501-2404 2015-01-14
1720477714 Lacey Grimes Lichtenstein Nurse Practitioner 1340 Broad Ave, Gulfport, MS 39501-2404 2015-01-14
1669872974 Jamie B Varnado Social Worker 1340 Broad Ave, Ste 410, Gulfport, MS 39501-2404 2014-08-25
1700121209 Danielle Ronquille Lipski Occupational Therapist 1340 Broad Ave, Suite 270, Gulfport, MS 39501-2404 2012-12-10
1164767778 Shannon Ann Church Social Worker 1340 Broad Ave, Ste 410, Gulfport, MS 39501-2404 2012-12-07
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1598301632 Daniel Edward Bloom Physician Assistant Naval Branch Health Clinic Gulfport, 5502 Marvin Shields Blvd, Gulfport, MS 39501 2019-11-25
1730721374 Affinity Healthcare LLC Non-emergency Medical Transport (VAN) 1822 15th St, Suite 8, Gulfport, MS 39501 2019-10-15
1093361156 Gulf Coast Companion Care, LLC Home Health 1314 Pass Road, Ste B, Gulfport, MS 39501 2019-08-14
1609420991 Greg Meekin Ent Otolaryngology 1201 31st Avenue, Gulfport, MS 39501 2019-07-25
1225681216 Murphy Chiropractic Gulfport, LLC Clinic/Center 2700 25th Ave., Gulfport, MS 39501 2019-07-19
1477022838 Patriot Healthcare of Mississippi, LLC Family Medicine 1110 Broad Street, Suite 300, Gulfport, MS 39501 2018-11-15
1477003028 Mindful Matters Nurse Practitioner 1613 23rd Avenue, Gulfport, MS 39501 2016-10-06
1902294093 Tangular Barnes Nurse Practitioner Gulf Coast Mental Health Center, 1600 Broad Ave, Gulfport, MS 39501 2014-12-25
1487065355 Huong Nguyen Pharmacist 2433 25th Avenue, Gulfport, MS 39501 2014-05-14
1770907412 Matthew Coleman Military Health Care Provider Nbhc Naval Construction Battalion Center Gulfport, 5501 Marvin Shields Blvd, Gulfport, MS 39501 2014-02-18
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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1487027504 Advanced Surgical Assistants LLC Physician Assistant 1924 30th Ave Ste A, Gulfport, MS 39501-4534 2015-11-11
1326478744 William Bishop Physician Assistant 11476 Savannah Pl, Gulfport, MS 39503-1109 2013-11-21
1376840173 Christopher Lawrence Sweebe Physician Assistant 741 Beaus Landing Dr, Gulfport, MS 39507-4347 2011-02-15
1528275633 Tina M Mcginty Physician Assistant 250 Church Ave, Gulfport, MS 39507-1255 2007-05-17
1639736432 Johnathon R Herron Physician Assistant 4500 13th St, Gulfport, MS 39501-2515 2019-05-28
1245613694 John Miyakawa Physician Assistant 12337 Ashley Dr, Suite F, Gulfport, MS 39503-2753 2015-07-02
1366864811 Latricia Rochelle Allen Physician Assistant 741 Beaus Landing Dr, Gulfport, MS 39507-4347 2014-01-16
1851688618 Precision Surgical Resources Physician Assistant 741 Beaus Landing Dr, Gulfport, MS 39507-4347 2011-06-30
1588829048 Darrell Bernard Colliers Physician Assistant 15200 Community Rd, Gulfport, MS 39523 2008-07-24

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1477091742 Madeline Grace Daniels Physician Assistant 501 Marshall St Ste 400, Jackson, MS 39202-1687 2017-02-07
1114392172 Robin Rae Hoffeld Physician Assistant 11401 Wedgewood Ln, Ocean Springs, MS 39564-7910 2015-12-02
1063889509 Julie Dianne Sullivan Physician Assistant 216 Linda Dr, Ocean Springs, MS 39564-4114 2015-09-01
1922190271 Robert L. Gillum Jr. Physician Assistant 6099 Adaughtery Rd, Suite A, Long Beach, MS 39560 2006-09-28
1841249489 Bradley Martin Physician Assistant 1014 Biglane Drive, Brookhaven, MS 39601 2006-05-10
1144293655 David Bradley Robbins Physician Assistant 206 Oxford Rd, New Albany, MS 38652-3115 2006-02-07
1801877022 Benjamin P Watts Physician Assistant 3615 Hospital St, Pascagoula, MS 39581-4112 2005-11-07
1972133353 Justin Bryant Schopp Physician Assistant 1325 E Fortification St, Jackson, MS 39202-2442 2020-01-24
1275163727 Kaitlin Lehto Physician Assistant 971 Lakeland Dr Ste 1460, Jackson, MS 39216-4684 2020-01-23
1154951739 Hailey Daniels Kelly Physician Assistant 1325 E Fortification St, Jackson, MS 39202-2442 2020-01-22
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Competitor

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City GULFPORT
Zip Code 39501

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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