Provider Demographics
NPI:1003808593
Name:AN, YOUNG H (MD)
Entity Type:Individual
Prefix:DR
First Name:YOUNG
Middle Name:H
Last Name:AN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 HIGHWAY 54 W BLDG 700 STE 710
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-4565
Mailing Address - Country:US
Mailing Address - Phone:770-991-2800
Mailing Address - Fax:770-997-3827
Practice Address - Street 1:1240 HIGHWAY 54 W BLDG 700 STE 710
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-4565
Practice Address - Country:US
Practice Address - Phone:770-991-2800
Practice Address - Fax:770-997-3827
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA052050207YS0012X
GA52050207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YS0012XAllopathic & Osteopathic PhysiciansOtolaryngologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA7388707OtherAETNA
GA12308453OtherMULTIPLAN
GA89124771AMedicaid
GA6376OtherKAISER PERMANENTE
GA52887621OtherBCBS OF GEORGIA
GA89124771CMedicaid
GA8711892OtherCIGNA
GA89124771BMedicaid
GA8711892OtherCIGNA
GA04BDCQBMedicare ID - Type Unspecified