Provider Demographics
NPI:1497936215
Name:YOUNG, JOHN CLAYTON (OD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CLAYTON
Last Name:YOUNG
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:232 CRAFTON INGRAM SHP CTR
Mailing Address - Street 2:
Mailing Address - City:CRAFTON
Mailing Address - State:PA
Mailing Address - Zip Code:15205-2353
Mailing Address - Country:US
Mailing Address - Phone:412-922-2305
Mailing Address - Fax:412-922-0688
Practice Address - Street 1:232 CRAFTON INGRAM SHP CTR
Practice Address - Street 2:
Practice Address - City:CRAFTON
Practice Address - State:PA
Practice Address - Zip Code:15205-2353
Practice Address - Country:US
Practice Address - Phone:412-922-2305
Practice Address - Fax:412-922-0688
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-20
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOET-009060152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist