# PLYMOUTH FAMILY PRACTICE CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194842922
- **Authorized official:** DR. KEVIN I YOUNG M.D. (SOLE PROPRIETOR)
- **Authorized official phone:** (603) 536-2502

## Contact information

- **Practice address:** 1 WARREN ST, PLYMOUTH, NH 03264-1416
- **Practice address phone:** (603) 536-2502
- **Practice address fax:** (603) 536-2503
- **Mailing address:** 1 WARREN ST, PLYMOUTH, NH 03264-1416
- **Mailing address phone:** (603) 536-2502
- **Mailing address fax:** (603) 536-2503

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 6405 | NH | Yes |

## Other

- **Enumeration date:** 03/25/2007
- **Last updated:** 01/09/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 30005343 | — | NH |
| 01 | — | 3444 | CIGNA | NH |
| 01 | — | PLYMO80156 | ANTHEM | NH |