Provider Demographics
NPI:1285675348
Name:YOUNT, PHILIP C (MD)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:C
Last Name:YOUNT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:100 KIMEL FOREST DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6074
Mailing Address - Country:US
Mailing Address - Phone:336-716-1331
Mailing Address - Fax:336-716-3202
Practice Address - Street 1:151 MEDICAL PARK DRIVE
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:NC
Practice Address - Zip Code:28640
Practice Address - Country:US
Practice Address - Phone:336-246-7161
Practice Address - Fax:336-246-6183
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC31941207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8989867Medicaid
NC562261381BOtherCIGNA
NC89867OtherBCBS
C87338Medicare UPIN
NC211778GMedicare ID - Type Unspecified