Provider Demographics
NPI:1528027612
Name:YOUNG, VICTORIA G (OD)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:G
Last Name:YOUNG
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:1227 HATCHER LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401
Mailing Address - Country:US
Mailing Address - Phone:931-388-3604
Mailing Address - Fax:931-388-9515
Practice Address - Street 1:1227 HATCHER LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401
Practice Address - Country:US
Practice Address - Phone:931-388-3604
Practice Address - Fax:931-388-9515
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNOD0000001656152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2240332OtherUNITED HEALTHCARE
TN3080841OtherBCBS
U62277Medicare UPIN
TN3080841OtherBCBS
TN6444480001Medicare NSC