Healthcare Provider Details

I. General information

NPI: 1356312912
Provider Name (Legal Business Name): KEVIN W. YOUNG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2006
Last Update Date: 09/13/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 COURT ST
VILLE PLATTE LA
70586-5248
US

IV. Provider business mailing address

207 TOURAINE CIR
LAFAYETTE LA
70501-3228
US

V. Phone/Fax

Practice location:
  • Phone: 337-363-5525
  • Fax: 337-363-1567
Mailing address:
  • Phone: 337-224-8620
  • Fax: 337-262-4160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD.09967R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: