Healthcare Provider Details

I. General information

NPI: 1649275546
Provider Name (Legal Business Name): SANDRA SINDEL YOUNG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 03/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 31 BOX 310
DEER AR
72628-0130
US

IV. Provider business mailing address

HC 31 BOX 310
DEER AR
72628-0130
US

V. Phone/Fax

Practice location:
  • Phone: 870-428-5391
  • Fax: 870-428-5392
Mailing address:
  • Phone: 870-428-5391
  • Fax: 870-428-5392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC4657
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: