Provider Demographics
NPI:1407177900
Name:YOUNG, PATRICIA GILLIGAN (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:GILLIGAN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:ANNE
Other - Last Name:GILLIGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2123 AUBURN AVE STE A44
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2906
Mailing Address - Country:US
Mailing Address - Phone:513-585-2791
Mailing Address - Fax:513-585-3882
Practice Address - Street 1:2123 AUBURN AVE STE A44
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-585-2791
Practice Address - Fax:513-585-3882
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35126045207RI0200X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0139538Medicaid
KY7100387410Medicaid