Provider Demographics
NPI:1750842894
Name:YOUNG, LAUREN MICHELLE (MD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:MICHELLE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:MICHELLE
Other - Last Name:EHLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11013 HEFNER POINTE DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-5035
Mailing Address - Country:US
Mailing Address - Phone:405-751-2020
Mailing Address - Fax:405-751-3838
Practice Address - Street 1:11013 HEFNER POINTE DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-5035
Practice Address - Country:US
Practice Address - Phone:405-751-2020
Practice Address - Fax:405-751-3838
Is Sole Proprietor?:No
Enumeration Date:2019-03-30
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK43328207W00000X, 207WX0110X
TXBP20073166207W00000X
KY57978207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXBP20073166OtherPHYSICIAN IN TRAINING NUMBER