Provider Demographics
NPI:1164421244
Name:YOUNG, JOHN SAMUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SAMUEL
Last Name:YOUNG
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 1:140 CHERRYFIELD LN
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-9095
Mailing Address - Country:US
Mailing Address - Phone:912-961-9721
Mailing Address - Fax:912-303-3614
Practice Address - Street 1:1061 HARMON AVE
Practice Address - Street 2:SUITE 1D03, WINN ARMY HOSPITAL
Practice Address - City:FORT STEWART
Practice Address - State:GA
Practice Address - Zip Code:31314-5604
Practice Address - Country:US
Practice Address - Phone:912-435-6633
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA026210207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine