Provider Demographics
NPI:1649275546
Name:YOUNG, SANDRA SINDEL (MD)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:SINDEL
Last Name:YOUNG
Suffix:
Gender:F
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:HC 31 BOX 310
Mailing Address - Street 2:
Mailing Address - City:DEER
Mailing Address - State:AR
Mailing Address - Zip Code:72628-0130
Mailing Address - Country:US
Mailing Address - Phone:870-428-5391
Mailing Address - Fax:870-428-5392
Practice Address - Street 1:HC 31 BOX 310
Practice Address - Street 2:
Practice Address - City:DEER
Practice Address - State:AR
Practice Address - Zip Code:72628-0130
Practice Address - Country:US
Practice Address - Phone:870-428-5391
Practice Address - Fax:870-428-5392
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC4657207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR104262001Medicaid
AR104262001Medicaid
55920Medicare PIN