Provider Demographics
NPI:1538456470
Name:YOUNG, WESTON GLADE (DO)
Entity Type:Individual
Prefix:DR
First Name:WESTON
Middle Name:GLADE
Last Name:YOUNG
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:3815 E BELL RD STE 2200
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2139
Mailing Address - Country:US
Mailing Address - Phone:602-633-3848
Mailing Address - Fax:602-633-3841
Practice Address - Street 1:3815 E BELL RD STE 4100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2167
Practice Address - Country:US
Practice Address - Phone:602-494-5040
Practice Address - Fax:602-494-4020
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2023-02-15
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Provider Licenses
StateLicense IDTaxonomies
WY390200000X207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine