Young, Gregory W
Young, Gregory W is an individual health care provider with primary practice located at 6809 122Nd Ave , Kenosha WI 53142-7335. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Young, Gregory W can be contacted via phone (262) 654-8633.Contact Information
Primary practice address
6809 122Nd Ave
Kenosha WI 53142-7335
Phone: (262) 654-8633
Fax: (262) 654-5467
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 20264 | Wisconsin |
Profile Details
| NPI number | 1194710129 |
|---|---|
| LBN Legal business name | Young, Gregory W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 15th, 2005 |
| Last updated | Feb 13th, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194710129 | NPPES |
| Wisconsin | MEDICAID | 30211300 |
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