Individual
LISA JACKSON YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7460 WOLF RIVER BOULEVARD, GERMANTOWN, TN 38138
(901) 763-0200
(901) 260-1713
Mailing address
1211 UNION AVE STE 330, MEMPHIS, TN 38104-6655
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
38424
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01575895
—
MS
05
—
154284001
—
AR
05
—
3891911
—
TN
01
—
4270159
BCBS
TN
01
—
P00882938
RAILROAD MEDICARE
TN
Enumeration date
08/01/2005
Last updated
05/23/2024
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