| Doctor Name: | DR. ROGER B. YOUNG |
| NPI Number: | 1235127358 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 18033 |
| Business Practice Address: | 2020 South I-35 Service Rd. Moore, OK - 73160 |
| Business Phone Number: | 4053668339 |
| Business Fax Number: | |
| Mailing Address: | 2119 Riverwalk Dr, Suite 195 MOORE |
| State: | OK |
| Postal Code: | 731602700 |
| Phone Number: | 4053668339 |
| Fax Number: | |
| NPI Enumeration Date: | 10/12/2005 |
| NPI Last Update Date: | 04/13/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 18033 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |