# GERALD LEE YOUNG MD PA

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

## Provider details

- **NPI number:** 1336443258
- **Authorized official:** DR. GERALD L YOUNG M.D. (PRESIDENT)
- **Authorized official phone:** (208) 547-4961

## Contact information

- **Practice address:** 366 S 3RD W, SODA SPRINGS, ID 83276-1559
- **Practice address phone:** (208) 547-4961
- **Practice address fax:** (208) 547-3781
- **Mailing address:** 366 S 3RD W, SODA SPRINGS, ID 83276-1559
- **Mailing address phone:** (208) 547-4961
- **Mailing address fax:** (208) 547-3781

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | M3234 | ID | Yes |

## Other

- **Enumeration date:** 01/06/2011
- **Last updated:** 03/22/2011