Healthcare Provider Details

I. General information

NPI: 1710447362
Provider Name (Legal Business Name): CONNOR SCOTT YOUNG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1816 PHILADELPHIA ST
AMES IA
50010-8771
US

IV. Provider business mailing address

PO BOX 677080
DALLAS TX
75267-7080
US

V. Phone/Fax

Practice location:
  • Phone: 515-232-2500
  • Fax: 515-246-4479
Mailing address:
  • Phone: 515-633-3600
  • Fax: 515-633-3838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD-54432
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125.074821
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036158293
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: