Provider Demographics
NPI:1295709905
Name:YOUNGER, PERRY WARD (MD)
Entity type:Individual
Prefix:DR
First Name:PERRY
Middle Name:WARD
Last Name:YOUNGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:PERRY
Other - Middle Name:WARD
Other - Last Name:YOUNGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:8135 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-6244
Mailing Address - Country:US
Mailing Address - Phone:330-758-0900
Mailing Address - Fax:724-545-9678
Practice Address - Street 1:518 WEST AVE
Practice Address - Street 2:
Practice Address - City:TALLMADGE
Practice Address - State:OH
Practice Address - Zip Code:44278-2117
Practice Address - Country:US
Practice Address - Phone:330-630-9699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD065707L207W00000X
OH35.149718207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG32154Medicare UPIN