Provider Demographics
NPI:1194817627
Name:YOUNG, DAVID JOSEPH (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOSEPH
Last Name:YOUNG
Suffix:
Gender:M
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:PO BOX 829641
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-0001
Mailing Address - Country:US
Mailing Address - Phone:267-370-5295
Mailing Address - Fax:215-230-3725
Practice Address - Street 1:595 W STATE ST
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2554
Practice Address - Country:US
Practice Address - Phone:215-345-0105
Practice Address - Fax:215-345-0562
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS005905L208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1194817627OtherGHP
PA0011621840007Medicaid
PA25-1645055OtherCIGNA-GREAT WEST HEALTHCARE
PA25-1645055OtherCOVENTRY/HEALTH AMERICA
PAP011117493OtherRR MEDICARE
PA0011621840006Medicaid
PA50110611OtherCAPITAL BLUE CROSS
PA829910OtherFPH
PA4113114OtherAETNA
PA0011621840006Medicaid
PA4113114OtherAETNA
PA1528625OtherGATEWAY HEALTH
PA109166OtherMEDICARE ADVANTAGE-PREMIER BLUE SHIELD