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Individual

DR. ROGER CHARLES YOUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
853 JEFFERSON AVE, E160, MEMPHIS, TN 38103-2807
(901) 448-1509
Mailing address
262 MEADOWGROVE LN, MEMPHIS, TN 38120-2611
(802) 658-4959

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
0420011205
VT
207VG0400X
Gynecology Physician
Primary
49929
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1532794
TN
05
198892001
AR
05
9202025
MS
Enumeration date
08/30/2006
Last updated
06/18/2014
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