Provider Demographics
NPI:1497834196
Name:YOUNG, WILLIAM M (RPH)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:M
Last Name:YOUNG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-4316
Mailing Address - Country:US
Mailing Address - Phone:334-749-3426
Mailing Address - Fax:334-742-0757
Practice Address - Street 1:512 2ND AVE
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-4316
Practice Address - Country:US
Practice Address - Phone:334-749-3426
Practice Address - Fax:334-742-0757
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6506183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist