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General NPI Number Information
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NPI Number | 1477561900
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Entity Type | Individual
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Provider Name | MARK R YOUNG MD
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Gender | Male
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 09/26/2019
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Provider Practice Location Address
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Address Line | 401 23RD ST STE 207
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City | GLENWOOD SPRINGS
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State | CO
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Zip | 81601-4382
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Country | US
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Telephone | 970-818-2587
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Fax |
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Provider Business Mailing Address
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Address Line | 401 23RD ST STE 207
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City | GLENWOOD SPRINGS
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State | CO
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Zip | 81601-4382
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Country | US
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Telephone | 970-818-2587
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Fax | 970-726-7954
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | DR44904
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License Number State | CO
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