Provider Demographics
NPI:1720062318
Name:YOUNG, EUGENE L (MD)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:L
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1330
Mailing Address - Country:US
Mailing Address - Phone:740-454-8193
Mailing Address - Fax:740-454-1470
Practice Address - Street 1:999 GARDEN RD
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1330
Practice Address - Country:US
Practice Address - Phone:740-454-8193
Practice Address - Fax:740-454-1470
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-060743207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0885234Medicaid
OH000000119764OtherANTHEM BLUE CROSS BLUE SHIELD
OHF37022Medicare UPIN
OH000000119764OtherANTHEM BLUE CROSS BLUE SHIELD
OH0885234Medicaid