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Individual

DR. JOHNNY SHAN YOUNG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
409 E 10TH ST STE 300, ANNISTON, AL 36207-4781
(256) 435-1399
(256) 435-1911
Mailing address
PO BOX 8061, ANNISTON, AL 36202-8061
(256) 435-1399
(256) 435-1911

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
15920
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00083944
AL
01
83944
BCBS PROVIDER
AL
Enumeration date
02/16/2006
Last updated
03/29/2018
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