Healthcare Provider Details

I. General information

NPI: 1265413637
Provider Name (Legal Business Name): ERIC E YOUNG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 06/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3830 GRANT AVENUE
LOVELAND CO
80538
US

IV. Provider business mailing address

3830 GRANT AVENUE
LOVELAND CO
80538
US

V. Phone/Fax

Practice location:
  • Phone: 970-776-3222
  • Fax: 970-776-3226
Mailing address:
  • Phone: 970-776-3222
  • Fax: 970-776-3226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number29876
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License NumberDR.0029876
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: