Healthcare Provider Details

I. General information

NPI: 1548433170
Provider Name (Legal Business Name): DARREN YOUNG PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2008
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS PLZ EMERGENCY DEPARTMENT
DAYTON OH
45404-1898
US

IV. Provider business mailing address

1 CHILDRENS PLZ EMERGENCY DEPARTMENT
DAYTON OH
45404-1898
US

V. Phone/Fax

Practice location:
  • Phone: 937-641-3600
  • Fax:
Mailing address:
  • Phone: 937-641-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50001708
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: