Provider Demographics
NPI:1275007502
Name:YOUNG, JEFFREY CHASE (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:CHASE
Last Name:YOUNG
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 HWY 111
Mailing Address - Street 2:
Mailing Address - City:BYRDSTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38549-1006
Mailing Address - Country:US
Mailing Address - Phone:931-864-3187
Mailing Address - Fax:
Practice Address - Street 1:8401 HWY 111
Practice Address - Street 2:
Practice Address - City:BYRDSTOWN
Practice Address - State:TN
Practice Address - Zip Code:38549-1006
Practice Address - Country:US
Practice Address - Phone:931-864-3187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-21
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3806363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant