Individual
DR. LISA DYER YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2401 VILLAGE PROFESSIONAL DRIVE, OPELIKA, AL 36801-4702
(334) 749-8121
(334) 749-6166
Mailing address
2401 VILLAGE PROFESSIONAL DRIVE, OPELIKA, AL 36801-4702
(334) 749-8121
(334) 749-6166
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
21253
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1210778
UNITED HEALTH PROV #
AL
01
—
177521
AAP ID
—
01
—
21253
ALABAMA CONTR SUBST CERT
AL
01
—
36452
AMERICAN BOARD PEDIATRICS
—
01
—
510-96612
BCBS AL PROV # OPELIKA
AL
01
—
510-96615
BCBS AL PROV # AUBURN
AL
Enumeration date
02/12/2007
Last updated
03/07/2023
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