Healthcare Provider Details

I. General information

NPI: 1083616932
Provider Name (Legal Business Name): CHARLES ARTHUR YOUNG M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 05/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 HOSPITAL CENTER BLVD
HILTON HEAD SC
29926
US

IV. Provider business mailing address

PO BOX 348
COLUMBUS GA
31902-0348
US

V. Phone/Fax

Practice location:
  • Phone: 843-689-8278
  • Fax:
Mailing address:
  • Phone: 912-486-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number055655
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: