Provider Demographics
NPI:1669410114
Name:SAMUEL M. YOUNG, M.D., PC.
Entity type:Organization
Organization Name:SAMUEL M. YOUNG, M.D., PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:MILTON
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:480-429-9200
Mailing Address - Street 1:7331 E OSBORN DR
Mailing Address - Street 2:SUITE 180
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6435
Mailing Address - Country:US
Mailing Address - Phone:480-429-9200
Mailing Address - Fax:480-429-9225
Practice Address - Street 1:13132 E LUPINE AVE
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-3614
Practice Address - Country:US
Practice Address - Phone:480-361-9650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ313552084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZC37362Medicare UPIN
AZ105884Medicare ID - Type Unspecified