Healthcare Provider Details
I. General information
NPI: 1992068183
Provider Name (Legal Business Name): AUSTIN YOUNGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/21/2012
Last Update Date: 01/25/2022
Certification Date: 01/21/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3290 DAUPHIN ST
MOBILE AL
36606-4062
US
IV. Provider business mailing address
6000 W HWY 98 UROLOGY DEPARTMENT
PENSACOLA FL
32512-0001
US
V. Phone/Fax
- Phone: 251-660-5930
- Fax: 251-660-5931
- Phone: 850-505-6485
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | LL 34921 |
| License Number State | SC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208800000X |
| Taxonomy | Urology Physician |
| License Number | ME133264 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: