Provider Demographics
NPI:1073559258
Name:YOUNG, MICHAEL E (DC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:E
Last Name:YOUNG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3510 W CENTRAL AVE
Mailing Address - Street 2:STE 900
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-4926
Mailing Address - Country:US
Mailing Address - Phone:316-729-7277
Mailing Address - Fax:316-636-7187
Practice Address - Street 1:3510 W CENTRAL AVE
Practice Address - Street 2:STE 900
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-4926
Practice Address - Country:US
Practice Address - Phone:316-729-7277
Practice Address - Fax:316-729-6825
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-03717111N00000X
KSC3717111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS014180OtherBCBS
KS023506Medicare ID - Type Unspecified
T44094Medicare UPIN