Provider Demographics
NPI:1518977701
Name:YOUNG, TIMOTHY RICHARD (DO)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:RICHARD
Last Name:YOUNG
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Gender:M
Credentials:DO
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Mailing Address - Street 1:1499 WALTON WAY
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2602
Mailing Address - Country:US
Mailing Address - Phone:706-733-0188
Mailing Address - Fax:706-823-3983
Practice Address - Street 1:1 FREEDOM WAY
Practice Address - Street 2:VAMC ORTHOPEDICS
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-6258
Practice Address - Country:US
Practice Address - Phone:706-733-0188
Practice Address - Fax:706-823-3983
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2011-05-11
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Provider Licenses
StateLicense IDTaxonomies
GA023418207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD41983Medicare UPIN