Individual
DR. CHARLES C YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1812 DALEY ST, RAWLINS, WY 82301-5912
(307) 324-6711
(307) 324-3594
Mailing address
1812 DALEY ST, RAWLINS, WY 82301-5912
(307) 324-6711
(307) 324-3594
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5353A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080086864
PALMETTO
WY
05
—
109204900
—
WY
01
—
307083
BLUE CROSS BLUE SHIELD
WY
01
—
344550
COMBINED INSURANCE
WY
01
—
490301955
LAB CORP
WY
01
—
5353A
LICENSE
WY
01
—
53D0909290
CLIA
WY
01
—
563365
WY WORKERS COMPENSATION
WY
01
—
850335622
TAX ID
WY
Enumeration date
10/02/2006
Last updated
03/07/2023
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