Healthcare Provider Details

I. General information

NPI: 1083841340
Provider Name (Legal Business Name): JASON S CHANG MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2009
Last Update Date: 10/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 S MAIN ST
FINDLAY OH
45840-1208
US

IV. Provider business mailing address

PO BOX 45490
WESTLAKE OH
44145-0490
US

V. Phone/Fax

Practice location:
  • Phone: 419-427-2604
  • Fax: 419-427-2607
Mailing address:
  • Phone: 800-514-4390
  • Fax: 440-808-3675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number35.091378
License Number StateOH

VIII. Authorized Official

Name: DR. JASON S CHANG
Title or Position: OWNER
Credential: MD
Phone: 419-427-2604