=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922688290
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CLAIRE YOUNG DO
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/12/2021
-----------------------------------------------------
Last Update Date | 08/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12 N THOMPSON ST
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23221-2718
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-359-1337
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 215 BRIGHTWATER DRIVE
-----------------------------------------------------
City | LILLINGTON
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27546-5156
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-892-1000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 0102209384
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------