Provider Demographics
NPI:1962497685
Name:YOUNG, STEVEN ROBERT (MD)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:ROBERT
Last Name:YOUNG
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1300 N 500 E
Mailing Address - Street 2:SUITE 220
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-2408
Mailing Address - Country:US
Mailing Address - Phone:435-753-5220
Mailing Address - Fax:435-753-5287
Practice Address - Street 1:1300 N 500 E
Practice Address - Street 2:SUITE 220
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-2408
Practice Address - Country:US
Practice Address - Phone:435-753-5220
Practice Address - Fax:435-753-5287
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-19
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
UT1748491205207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D87628Medicare UPIN