Provider Demographics
NPI:1649244773
Name:YOUNG, JOHN ADAM III (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ADAM
Last Name:YOUNG
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:15544 W COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-9556
Mailing Address - Country:US
Mailing Address - Phone:800-457-4573
Mailing Address - Fax:800-443-6422
Practice Address - Street 1:8550 NE 138TH LN STE 2000-C
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-8957
Practice Address - Country:US
Practice Address - Phone:800-457-4573
Practice Address - Fax:800-443-6422
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2024-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WV162812084N0400X
VA01012809532084P0800X
FLME1201422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0090219000Medicaid
WV3810005283Medicaid
E81652Medicare UPIN
WV0090219000Medicaid