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Individual

DR. GARY YOUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1255 HILYARD ST, EUGENE, OR 97401-3718
(541) 686-6932
Mailing address
PO BOX 4078, PORTLAND, OR 97208-4078
(888) 633-0086

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD12211
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
057221008
BCBS
05
077862
OR
01
104999
WA L & I
05
8280158
WA
01
A019
CHAMPUS
01
D70722
PROVIDENCE
05
XPY187524
CA
Enumeration date
05/25/2006
Last updated
12/19/2007
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