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NPI Code Detail

MEDICARE: DR. PAUL B YOUNG M.D.

MEDICARE: DR. PAUL B 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
1208000000XPediatrics Physician27882-020WI

Other Identifiers

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

General Provider Information

NPI Number : 1477548949
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL B YOUNG M.D.
Provider Business Mailing Address
First Line : 2825 HUNTERS TRL
Second Line :
City : PORTAGE
State : WI
Zip : 53901-3429
Country : US
Telephone Number : 608-742-7161
Fax Number : 608-745-3990
Provider Business Practice Location Address
First Line : 2825 HUNTERS TRL
Second Line :
City : PORTAGE
State : WI
Zip : 53901-3429
Country : US
Telephone Number : 608-742-7161
Fax Number : 608-745-3990
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2005
Last Update Date : 01/07/2021

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Directions to “ DR. PAUL B YOUNG M.D.” Practice Location

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