Provider Demographics
NPI:1679501860
Name:YOUNG, DAVID F (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:F
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 NE 6TH ST
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-1293
Mailing Address - Country:US
Mailing Address - Phone:541-479-3367
Mailing Address - Fax:541-479-0215
Practice Address - Street 1:1309 NE 6TH ST
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-1293
Practice Address - Country:US
Practice Address - Phone:541-479-3367
Practice Address - Fax:541-479-0215
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD12726207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR229492Medicaid
OR229492Medicaid