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General NPI Number Information
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NPI Number | 1619596103
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Entity Type | Individual
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Provider Name | CLAYTON TYLER YOUNG DO
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Gender | Male
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Dates
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Enumeration Date | 04/14/2020
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Last Update Date | 07/09/2024
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Provider Practice Location Address
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Address Line | 1901 TATE SPRINGS RD
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City | LYNCHBURG
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State | VA
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Zip | 24501-1109
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Country | US
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Telephone | 434-200-3027
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7527
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City | DUBLIN
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State | OH
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Zip | 43017-0727
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Country | US
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Telephone |
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 34.016033
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34.016033
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 0102208470
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License Number State | VA
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