Young, Jeffrey Paul
Young, Jeffrey Paul is an sole proprietor health care provider with primary practice located at 2011 Moores Ln , Texarkana TX 75503-1841. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Young, Jeffrey Paul can be contacted via phone (903) 792-2777.Contact Information
Primary practice address
2011 Moores Ln
Texarkana TX 75503-1841
Phone: (903) 792-2777
Fax: (903) 794-6728
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | E2607 | Arkansas |
| Other Service Providers / Specialist | 174400000X | 20679 | Oklahoma |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | K5033 | Texas |
Profile Details
| NPI number | 1215934062 |
|---|---|
| LBN Legal business name | Young, Jeffrey Paul |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 7th, 2005 |
| Last updated | Jun 12th, 2024 - about 6 months 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 | 1215934062 | NPPES |
| Other | 070012558 | RR MEDICARE | |
| MEDICAID | 031075701 | RR MEDICARE | |
| MEDICAID | 134647001 | RR MEDICARE |
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