Provider Demographics
NPI:1659661460
Name:J & E YOUNG
Entity Type:Organization
Organization Name:J & E YOUNG
Other - Org Name:YOUNG HEARING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JARED
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:AUD, FAA, CCC-A
Authorized Official - Phone:801-489-7948
Mailing Address - Street 1:528 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84663-1073
Mailing Address - Country:US
Mailing Address - Phone:801-489-7948
Mailing Address - Fax:801-491-0530
Practice Address - Street 1:528 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:UT
Practice Address - Zip Code:84663-1073
Practice Address - Country:US
Practice Address - Phone:801-489-7948
Practice Address - Fax:801-491-0530
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YOUNG HEARING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5151504-41401231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT235263OtherALTIUS
UT528716061001Medicaid
UT5800602Medicare PIN