Provider Demographics
NPI:1477507200
Name:YOUNG, MICHAEL S (MD)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:S
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 430
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-0430
Mailing Address - Country:US
Mailing Address - Phone:866-898-7136
Mailing Address - Fax:616-975-9827
Practice Address - Street 1:170 NORTH 1100 EAST
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003
Practice Address - Country:US
Practice Address - Phone:801-714-6570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT321681207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT107007614102OtherSELECT HEALTH
UT870636000YO1OtherEDUCATORS MUTUAL
UT307985OtherDESERET MUTUAL
UTD1931Medicaid
UT870636000YO1OtherEDUCATORS MUTUAL
UT107007614102OtherSELECT HEALTH
UT006294021Medicare PIN
UT307985OtherDESERET MUTUAL