Individual
MITCHELL YOUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
815 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2224
(817) 321-0387
Mailing address
815 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2224
(817) 321-0404
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
L2766
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146492703
—
TX
05
—
146492711
—
TX
Enumeration date
05/31/2005
Last updated
10/02/2018
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