Individual
DR. JOHN VINCENT YOUNG JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8106 E CHAMPIONS ST, WICHITA, KS 67226-3324
(410) 336-6773
(410) 427-5511
Mailing address
8106 E CHAMPIONS ST, WICHITA, KS 67226-3324
(410) 336-6773
(410) 427-5511
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
435332
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113621
—
OR
05
—
200750860A
—
KS
01
—
P01024270
RR MEDICARE
KS
Enumeration date
12/11/2006
Last updated
02/20/2014
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