Healthcare Provider Details

I. General information

NPI: 1497384200
Provider Name (Legal Business Name): EMERY LLEWELLYN YOUNG JR. DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2020
Last Update Date: 12/10/2024
Certification Date: 12/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 MOCKSVILLE AVE
SALISBURY NC
28144-2786
US

IV. Provider business mailing address

611 MOCKSVILLE AVE
SALISBURY NC
28144-2786
US

V. Phone/Fax

Practice location:
  • Phone: 704-633-7220
  • Fax: 704-647-0515
Mailing address:
  • Phone: 704-633-7220
  • Fax: 704-647-0515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2023-0249
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: