Doctor Name: | JOHN H YOUNG |
NPI Number: | 1467481705 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | C-3226 |
Business Practice Address: | 117 E Sycamore St Fayetteville, AR - 727032540 |
Business Phone Number: | 4795210200 |
Business Fax Number: | 4795214942 |
Mailing Address: | Po Box 3531, FAYETTEVILLE |
State: | AR |
Postal Code: | 727023531 |
Phone Number: | 4795210200 |
Fax Number: | 4795214942 |
NPI Enumeration Date: | 06/30/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | C-3226 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |