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Individual

DR. STEPHEN KYLE YOUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
120 EXECUTIVE PARK, LOUISVILLE, KY 40207
(502) 855-7200
(502) 855-7201
Mailing address
PO BOX 21890, BELFAST, ME 04915-4115
(502) 907-0356
(502) 919-9780

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
01068095A
IN
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
43136
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000834292
ANTHEM ID
05
200959940
IN
05
7100080590
KY
01
9806467
AETNA PIN
01
CS1429300150
CARESOURCE ID
Enumeration date
02/13/2007
Last updated
02/13/2024
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