Healthcare Provider Details

I. General information

NPI: 1790856219
Provider Name (Legal Business Name): ROBERT J YOUNG III APMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 09/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2774 RODEO ROAD
ABBEVILLE LA
70511
US

IV. Provider business mailing address

PO BOX 2133
ABBEVILLE LA
70511-2133
US

V. Phone/Fax

Practice location:
  • Phone: 337-893-8976
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1100X
TaxonomyOphthalmic Technician/Technologist
License Number
License Number State

VIII. Authorized Official

Name: ROBERT J YOUNG
Title or Position: OWNER, PHYSICIAN
Credential: MD
Phone: 337-893-8976