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General NPI Number Information
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NPI Number | 1669662946
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Entity Type | Organization
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Legal Business Name | HENRY T. YOUNG, JR., M.D.
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Dates
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Enumeration Date | 08/01/2007
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Last Update Date | 06/27/2008
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Provider Practice Location Address
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Address Line | 1286 DEL ESTE AVE
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City | DENHAM SPRINGS
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State | LA
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Zip | 70726-4898
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Country | US
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Telephone | 225-667-3100
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Fax | 225-667-5443
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Provider Business Mailing Address
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Address Line | 1286 DEL ESTE AVE
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City | DENHAM SPRINGS
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State | LA
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Zip | 70726-4898
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Country | US
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Telephone | 225-667-3100
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Fax | 225-667-5443
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Authorized Official
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Title or Position | BUSINESS OWNER/ PHYSICIAN
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Name | DR. HENRY T YOUNG JR.
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Credential | M.D
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Telephone | 225-667-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 016391
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License Number State | LA
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