Provider Demographics
NPI:1629186143
Name:WILLIAM LEE YOUNG III
Entity Type:Organization
Organization Name:WILLIAM LEE YOUNG III
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:828-465-0811
Mailing Address - Street 1:1088 12TH AVENUE LN NW
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-2301
Mailing Address - Country:US
Mailing Address - Phone:828-465-0811
Mailing Address - Fax:828-465-0811
Practice Address - Street 1:1088 12TH AVENUE LN NW
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-2301
Practice Address - Country:US
Practice Address - Phone:828-465-0811
Practice Address - Fax:828-465-0811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22078207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89-89799Medicaid
NCDC0983OtherMEDICARE RAILROAD
NC89799OtherBCBS
NCC87333Medicare UPIN
NC89-89799Medicaid