MEDICARE: DR. DONALD CARLETON YOUNG D.O.

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	207VE0102X	Reproductive Endocrinology Physician	02198	IA

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

General Provider Information

NPI Number	:	1861496739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD CARLETON YOUNG D.O.

Provider Business Mailing Address
First Line	:	1371 NW 121ST ST
Second Line	:
City	:	CLIVE
State	:	IA
Zip	:	50325-8143
Country	:	US
Telephone Number	:	515-222-3060
Fax Number	:	515-222-9563

Provider Business Practice Location Address
First Line	:	1371 NW 121ST ST
Second Line	:
City	:	CLIVE
State	:	IA
Zip	:	50325-8143
Country	:	US
Telephone Number	:	515-222-3060
Fax Number	:	515-222-9563

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	07/08/2007

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