MEDICARE: MARIANNE MISCIAGNA YOUNG M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician	17830	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427055169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIANNE MISCIAGNA YOUNG M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1072
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73070-1072
Country	:	US
Telephone Number	:	405-329-4581
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 N LEE AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73102-1036
Country	:	US
Telephone Number	:	405-272-7311
Fax Number	:	405-272-2845

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	01/19/2017

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