Organization
DEYOUNG FAMILY MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS B DEYOUNG DO (OWNER)
(970) 215-7910
Entity
Organization
Contact information
Practice address
1024 CENTRE AVE, BLD E STE 100A, FORT COLLINS, CO 80526-1887
(970) 495-0300
(970) 224-9624
Mailing address
1175 58TH AVE, STE 202, GREELEY, CO 80634-4807
(970) 495-0300
(970) 224-9624
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27536
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DED27536
ANTHEM
CO
Enumeration date
10/24/2007
Last updated
03/07/2011
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