Provider Demographics
NPI:1376607259
Name:YOUNG, JOSHUA OLSEN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:OLSEN
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5410 OLD HICKORY BLVD
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-2574
Mailing Address - Country:US
Mailing Address - Phone:615-883-2356
Mailing Address - Fax:
Practice Address - Street 1:5410 OLD HICKORY BLVD
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-2574
Practice Address - Country:US
Practice Address - Phone:615-883-2356
Practice Address - Fax:615-872-0863
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN41562207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3000251Medicare PIN
TNX86630Medicare UPIN