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Individual

GEORGIA L YOUNG

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
214 E 23RD ST, CHEYENNE, WY 82001-3748
(307) 638-0300
(307) 638-0394
Mailing address
PO BOX 2417, CHEYENNE, WY 82003-2417
(307) 638-0300
(307) 638-0394

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
6315A
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
310059
BLUE CROSS BLUE SHIELD
WY
Enumeration date
06/13/2006
Last updated
07/08/2007
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