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NPI Code Detail

MEDICARE: ARTHUR T YOUNG O.D.

MEDICARE: ARTHUR T YOUNG O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOPC789FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
419800XOTHERFLMEDICARE ID UNSPECIFIED

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
219800OTHERFLBLUE CROSS BLUE SHIELD
35848106OTHERFLAETNA
54785695OTHERFLCIGNA

General Provider Information

NPI Number : 1235192337
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARTHUR T YOUNG O.D.
Provider Business Mailing Address
First Line : 4101 EVANS AVE
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-9310
Country : US
Telephone Number : 239-939-3456
Fax Number : 239-936-8212
Provider Business Practice Location Address
First Line : 4101 EVANS AVE
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-9310
Country : US
Telephone Number : 239-939-3456
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2006
Last Update Date : 07/31/2008

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