Healthcare Provider Details

I. General information

NPI: 1851826770
Provider Name (Legal Business Name): SARAH BETH YOUNG D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2017
Last Update Date: 01/19/2023
Certification Date: 01/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9660 E 146TH ST STE 100
NOBLESVILLE IN
46060-3097
US

IV. Provider business mailing address

9660 E 146TH ST
NOBLESVILLE IN
46060-3099
US

V. Phone/Fax

Practice location:
  • Phone: 317-773-6677
  • Fax:
Mailing address:
  • Phone: 330-933-5439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number02006729A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: