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Individual

MR. JEFFREY MILTON YOUNG

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
13677 W MCDOWELL RD, GOODYEAR, AZ 85338-2618
(623) 882-1500
Mailing address
708 S WINDSOR, MESA, AZ 85204-3814
(480) 610-9794

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2072
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3981220
EVERCARE GROUP NUMBER
AZ
01
AW1436
HEALTHNET GROUP NUMBER
AZ
01
AZ0728670
BLUE CROSS BLUE SHIELD GR
AZ
Enumeration date
11/07/2005
Last updated
07/08/2007
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