Individual
MARK R YOUNG
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1504 N 1ST ST, INDIANOLA, IA 50125-3702
(515) 961-3700
(515) 962-0160
Mailing address
1504 N 1ST ST, INDIANOLA, IA 50125-3702
(515) 961-3700
(515) 962-0160
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24278
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0221515
—
IA
05
—
1221515
—
IA
05
—
2221515
—
IA
05
—
4221515
—
IA
Enumeration date
12/29/2005
Last updated
07/09/2007
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