Provider Demographics
NPI:1114248523
Name:YOUNG, MARGARET JOAN (DO)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:JOAN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 S GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SCHUYLKILL HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17972-1107
Mailing Address - Country:US
Mailing Address - Phone:570-385-3826
Mailing Address - Fax:570-385-4125
Practice Address - Street 1:523 S GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:SCHUYLKILL HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17972-1107
Practice Address - Country:US
Practice Address - Phone:570-385-3826
Practice Address - Fax:570-385-4125
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-21
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS 015866207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1114248523OtherNPI