Organization
YOUNG ARIZONA PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DENICE M YOUNG (ADMINISTRATOR)
(623) 214-3454
Entity
Organization
Contact information
Practice address
15653 N REEMS RD STE 110, SURPRISE, AZ 85374-9541
(623) 214-3454
(623) 214-3455
Mailing address
15653 N REEMS RD STE 110, SURPRISE, AZ 85374-9541
(623) 214-3454
(623) 214-3455
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
33964
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
954679
AHCCCS
AZ
Enumeration date
08/05/2011
Last updated
08/05/2011
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