Healthcare Provider Details

I. General information

NPI: 1407063068
Provider Name (Legal Business Name): KAREN YOUNG MD.PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 08/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2302 COLLEGE AVE
CONWAY AR
72034-6297
US

IV. Provider business mailing address

PO BOX 11469
CONWAY AR
72034-0025
US

V. Phone/Fax

Practice location:
  • Phone: 501-329-3831
  • Fax:
Mailing address:
  • Phone: 501-554-2350
  • Fax: 501-847-4822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC7770
License Number StateAR

VIII. Authorized Official

Name: DR. KAREN L YOUNG
Title or Position: PHYSICIAN
Credential: MD
Phone: 501-554-2350