1396724837 NPI number — DR. BARBARA KAREN CHANG-WAI-LING M.D.

Table of content: DR. BARBARA KAREN CHANG-WAI-LING M.D. (NPI 1396724837)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396724837 NPI number — DR. BARBARA KAREN CHANG-WAI-LING M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHANG-WAI-LING
Provider First Name:
BARBARA
Provider Middle Name:
KAREN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHANG
Provider Other First Name:
BARBARA
Provider Other Middle Name:
KAREN
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1396724837
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/04/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 279
Provider Second Line Business Mailing Address:
405 INDIANA AVENUE
Provider Business Mailing Address City Name:
MILLTOWN
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47145-0279
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-287-4722
Provider Business Mailing Address Fax Number:
502-287-4541

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 ZORN AVE
Provider Second Line Business Practice Location Address:
VA MEDICAL CENTER; BLDG 5-5109
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40206-1433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-387-4722
Provider Business Practice Location Address Fax Number:
502-287-4541
Provider Enumeration Date:
01/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , with the licence number:  019654 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X , with the licence number: 95-24 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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