MEDICARE: JEFFREY A. YOUNG M.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
1	2085R0001X	Radiation Oncology Physician	012837	ME

General Provider Information

NPI Number	:	1477561207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY A. YOUNG M.D.

Provider Business Mailing Address
First Line	:	111 GREELY RD
Second Line	:
City	:	CUMBERLAND
State	:	ME
Zip	:	04021-3800
Country	:	US
Telephone Number	:	207-650-2818
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 GREELY RD
Second Line	:
City	:	CUMBERLAND
State	:	ME
Zip	:	04021-3800
Country	:	US
Telephone Number	:	207-650-2818
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	09/21/2012

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