MEDICARE: PAYTON S YOUNG

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1467302133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAYTON S YOUNG

Provider Business Mailing Address
First Line	:	190 W HOGERSON ST
Second Line	:
City	:	BUFFALO
State	:	WY
Zip	:	82834-1502
Country	:	US
Telephone Number	:	307-680-0704
Fax Number	:

Provider Business Practice Location Address
First Line	:	190 W HOGERSON ST
Second Line	:
City	:	BUFFALO
State	:	WY
Zip	:	82834-1502
Country	:	US
Telephone Number	:	307-680-0704
Fax Number	:

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

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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Directions to “ PAYTON S YOUNG ” Practice Location

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