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Individual

DR. THOMAS A YOUNG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
211 E HAVENS ST, MITCHELL, SD 57301-4402
(605) 996-4671
(605) 996-4671
Mailing address
211 E HAVENS ST, MITCHELL, SD 57301-4402
(605) 996-4671
(605) 996-4671

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
451
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0076548
BLUE CROSS BLUE SHIELD
SD
01
0530030001
DMERC
SD
01
4266
AVERA HEALTH PLANS
SD
05
9201890
SD
01
P00849313
RAILROAD MEDICARE
SD
Enumeration date
08/01/2006
Last updated
10/18/2010
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