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Individual

DOUGLAS TRENT YOUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
2845 SIENA HEIGHTS DR, HENDERSON, NV 89052-4153
(702) 617-1227
(702) 492-1589
Mailing address
PO BOX 15645, LAS VEGAS, NV 89114-5645
(702) 242-7786
(702) 240-8790

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA636
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002402368
NV
05
1003889577
NV
Enumeration date
02/07/2006
Last updated
02/14/2014
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