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General NPI Number Information
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NPI Number | 1578495040
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Entity Type | Individual
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Provider Name | ANDREW YOUNG CHANG OD
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Gender | Male
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Dates
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Enumeration Date | 06/01/2026
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Last Update Date | 06/01/2026
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Provider Practice Location Address
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Address Line | 2090 FLORENCE AVE
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City | CINCINNATI
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State | OH
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Zip | 45206-2484
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Country | US
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Telephone | 513-559-3599
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Fax |
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Provider Business Mailing Address
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Address Line | 3009 S XAVIER CT
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City | BLOOMINGTON
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State | IN
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Zip | 47401-6883
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1800465A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT.007490
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License Number State | OH
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