Provider Demographics
NPI:1417050204
Name:YOUNGER, STEVEN K (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:K
Last Name:YOUNGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:STEVEN
Other - Middle Name:K
Other - Last Name:YOUNGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1701 W 26TH ST
Mailing Address - Street 2:STEB
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-1513
Mailing Address - Country:US
Mailing Address - Phone:417-627-8967
Mailing Address - Fax:417-627-8920
Practice Address - Street 1:2550 LUSK DR
Practice Address - Street 2:
Practice Address - City:NEOSHO
Practice Address - State:MO
Practice Address - Zip Code:64850-8855
Practice Address - Country:US
Practice Address - Phone:417-451-2060
Practice Address - Fax:417-451-2164
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007015099207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2007015099OtherLICENSE
MO206311706Medicaid
MO206311706Medicaid