Provider Demographics
NPI:1033344866
Name:YOUNG, THOMAS J (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:YOUNG
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Gender:M
Credentials:MD
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Mailing Address - Street 1:321 MULBERRY STREET, SW
Mailing Address - Street 2:MEDICAL STAFF SERVICES
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645
Mailing Address - Country:US
Mailing Address - Phone:828-757-5965
Mailing Address - Fax:828-757-5104
Practice Address - Street 1:401 MULBERRY STREET, SW
Practice Address - Street 2:SUITE 202
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645
Practice Address - Country:US
Practice Address - Phone:828-757-6146
Practice Address - Fax:828-757-6594
Is Sole Proprietor?:No
Enumeration Date:2009-05-22
Last Update Date:2021-03-19
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Provider Licenses
StateLicense IDTaxonomies
NC2015-00744208600000X
NC201500744208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCO304C674Medicare PIN