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General NPI Number Information
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NPI Number | 1639134976
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Entity Type | Individual
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Provider Name | RONDALL ATLEE YOUNG MD
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Gender | Male
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 09/11/2012
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Provider Practice Location Address
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Address Line | 719 GREEN VALLEY RD
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City | GREENSBORO
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State | NC
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Zip | 27408-7014
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Country | US
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Telephone | 336-272-9447
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Fax | 336-272-2112
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Provider Business Mailing Address
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Address Line | 719 GREEN VALLEY RD
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City | GREENSBORO
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State | NC
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Zip | 27408-7025
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Country | US
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Telephone | 336-272-9447
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Fax | 336-272-2112
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 30976
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License Number State | NC
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