Individual
DR. JEFFREY PAUL YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2011 MOORES LN, TEXARKANA, TX 75503-1841
(903) 792-2777
(903) 794-6728
Mailing address
2011 MOORES LN, TEXARKANA, TX 75503-1841
(903) 792-2777
(903) 794-6728
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
20679
OK
174400000X
Specialist
E2607
AR
207N00000X
Dermatology Physician
Primary
K5033
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031075701
—
TX
01
—
070012558
RR MEDICARE
—
05
—
134647001
—
AR
Enumeration date
07/07/2005
Last updated
06/12/2024
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