Healthcare Provider Details

I. General information

NPI: 1023045838
Provider Name (Legal Business Name): MICHAEL D YOUNG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 07/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 W JEFFERSON ST STE 202
FRANKLIN IN
46131-2732
US

IV. Provider business mailing address

1155 W JEFFERSON ST STE 202
FRANKLIN IN
46131-2732
US

V. Phone/Fax

Practice location:
  • Phone: 317-346-3883
  • Fax: 317-346-3141
Mailing address:
  • Phone: 812-372-8426
  • Fax: 812-372-8301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01042806A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: