Individual
DR. VINCENT MICHAEL YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
112 S. MAIN, BLANCHARD, OK 73010
(405) 485-3937
(405) 485-3642
Mailing address
PO BOX 325, BLANCHARD, OK 73010-0325
(405) 485-3937
(405) 485-3642
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2441
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200053840A
—
OK
01
—
OK2441
EYEMED
OK
Enumeration date
02/28/2006
Last updated
08/18/2010
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