Healthcare Provider Details

I. General information

NPI: 1770909780
Provider Name (Legal Business Name): JONATHAN ADAM YOUNGWIRTH DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2014
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4131A OREGON PIKE
EPHRATA PA
17522-9550
US

IV. Provider business mailing address

601 MEMORY LN
YORK PA
17402-2231
US

V. Phone/Fax

Practice location:
  • Phone: 717-859-1123
  • Fax: 717-859-2898
Mailing address:
  • Phone: 717-859-1405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberOKO000055
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS017844
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: