Individual
MALLORY LYNN YOUNGSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
682 HEMLOCK ST STE 210, MACON, GA 31201-8314
(478) 633-5300
(478) 633-5304
Mailing address
682 HEMLOCK ST STE 210, MACON, GA 31201-8314
(478) 633-5300
(478) 633-5304
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
85686
GA
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
85686
GA
Other
Enumeration date
03/29/2016
Last updated
06/25/2024
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