Organization
CLASSICAL PAEDIATRICS, AMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN CHRISTIAN YOUNG MD (PRESIDENT)
(318) 323-3996
Entity
Organization
Contact information
Practice address
920 OLIVER RD, SUITE 1475, MONROE, LA 71201-5702
(318) 323-3996
(318) 324-2181
Mailing address
3928 JEFFERSON DAVIS PL, MONROE, LA 71201-1957
(318) 325-9273
(318) 323-5339
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
09436R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1445797
—
LA
Enumeration date
05/25/2006
Last updated
08/22/2020
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