Individual
ANDREW JAO O'YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2508 BERT KOUNS INDUSTRIAL LOOP, SUITE 105, SHREVEPORT, LA 71118-3133
(318) 686-8808
(318) 212-5018
Mailing address
2508 BERT KOUNS INDUSTRIAL LOOP, SUITE 105, SHREVEPORT, LA 71118-3133
(318) 686-8808
(318) 212-5018
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13658R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1433128
—
LA
Enumeration date
06/30/2006
Last updated
10/04/2010
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