| Doctor Name: | JASON R YOUNG |
| NPI Number: | 1205224870 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CNP |
| License Number: | ATP000731 |
| Business Practice Address: | 643 E 3rd St Gentry, AR - 727348258 |
| Business Phone Number: | 4797362213 |
| Business Fax Number: | 4797362105 |
| Mailing Address: | Po Box 9, GENTRY |
| State: | AR |
| Postal Code: | 727340009 |
| Phone Number: | 4797362213 |
| Fax Number: | 4797362105 |
| NPI Enumeration Date: | 01/05/2015 |
| NPI Last Update Date: | 01/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | ATP000731 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |