Individual
DR. EVAN REESE YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1005 DALE MABRY HWY, LUTZ, FL 33548-3021
(813) 549-5678
(813) 701-9132
Mailing address
2511 W DR MARTIN LUTHER KING JR BLVD, TAMPA, FL 33607-6301
(813) 879-7850
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
PO4216
FL
213EP1101X
Primary Podiatric Medicine Podiatrist
PO4216
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO4216
FL
213ES0131X
Foot Surgery Podiatrist
PO4216
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108826400
—
FL
01
—
14953569
CAQH ID
—
01
—
4790067
AETNA ID
FL
01
—
8672007
CIGNA ID
FL
01
—
ISELD
BCBS
FL
Enumeration date
12/08/2011
Last updated
10/27/2023
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