Provider Demographics
NPI:1114980505
Name:YOUNG, WILLIAM O (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:O
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:1305 C WEST WENDOVER AVENUE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-8124
Mailing Address - Country:US
Mailing Address - Phone:336-271-2007
Mailing Address - Fax:336-271-2904
Practice Address - Street 1:1305 C WEST WENDOVER AVENUE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-8124
Practice Address - Country:US
Practice Address - Phone:336-271-2007
Practice Address - Fax:336-271-2904
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9400680207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
10773OtherBCBS
7503525OtherUHC
NC8989749Medicaid
NC8989749Medicaid
2199184AMedicare ID - Type Unspecified