Provider Demographics
NPI:1760526701
Name:YU, SAE YOUNG (OD)
Entity Type:Individual
Prefix:DR
First Name:SAE
Middle Name:YOUNG
Last Name:YU
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2626 HUNTERS PLACE LNDG
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:GA
Mailing Address - Zip Code:30017-7829
Mailing Address - Country:US
Mailing Address - Phone:770-289-7388
Mailing Address - Fax:
Practice Address - Street 1:730 NORTHSIDE DR E
Practice Address - Street 2:VISION CENTER
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-4766
Practice Address - Country:US
Practice Address - Phone:912-764-9750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2357152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist