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General NPI Number Information
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NPI Number | 1932693280
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Entity Type | Individual
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Provider Name | EVERETT GLENN YOUNG MD
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Gender | Male
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Dates
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Enumeration Date | 06/20/2018
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 1272 VIRGIL LANGFORD RD
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City | WATKINSVILLE
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State | GA
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Zip | 30677-7245
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Country | US
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Telephone | 770-292-6500
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Fax | 770-292-6535
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Provider Business Mailing Address
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Address Line | 1272 VIRGIL LANGFORD RD
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City | ATHENS
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State | GA
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Zip | 30606
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Country | US
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Telephone | 770-758-7903
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | TRN27081
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MD481748
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | 99894
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License Number State | GA
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