Provider Demographics
NPI:1750504734
Name:YOUNG, AARON M (MD)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:M
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:PO BOX 2968
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46515-2968
Mailing Address - Country:US
Mailing Address - Phone:574-296-3200
Mailing Address - Fax:
Practice Address - Street 1:2115 W LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-1423
Practice Address - Country:US
Practice Address - Phone:574-296-3950
Practice Address - Fax:574-296-3999
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11012613207Q00000X
IN01064005A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000620032OtherBCBS
IN200251620AMedicaid
IN200894430Medicaid
IN000000577719OtherBCBS
INP00646019OtherRR MEDICARE
IN200251620AMedicaid
IN257300EMedicare PIN