Young, Gerald L

Young, Gerald L is an sole proprietor health care provider with primary practice located at 366 S 3Rd W , Soda Springs ID 83276-1559. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Young, Gerald L can be contacted via phone (208) 547-4961.

Contact Information

Primary practice address
366 S 3Rd W Soda Springs ID 83276-1559
Phone: (208) 547-4961
Fax: (208) 547-3781
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X M3234 Idaho

Profile Details

NPI number 1649280256
LBN Legal business name Young, Gerald L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 8th, 2006
Last updated Mar 25th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649280256 NPPES
Idaho MEDICAID 0025019
Idaho Other 080191334
Idaho Other 000010006157
Idaho Other 32342

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