Healthcare Provider Details

I. General information

NPI: 1568564607
Provider Name (Legal Business Name): SARAH BETH YOUNGER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH BETH PATTON

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 KEENE ST
COLUMBIA MO
65201-6626
US

IV. Provider business mailing address

PO BOX 7687
COLUMBIA MO
65205-7687
US

V. Phone/Fax

Practice location:
  • Phone: 573-882-2272
  • Fax: 573-884-1795
Mailing address:
  • Phone: 573-882-2259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number2008022994
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2004015972
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number01089320A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: