Basic Information
| Provider Information | |||||||||
| NPI: | 1700863446 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YOUNG | ||||||||
| FirstName: | JOSHUA | ||||||||
| MiddleName: | Y | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4881 SUGAR MAPLE DR | ||||||||
| Address2: | |||||||||
| City: | WPAFB | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454335529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9372579844 | ||||||||
| FaxNumber: | 9376561347 | ||||||||
| Practice Location | |||||||||
| Address1: | 4881 SUGAR MAPLE DR | ||||||||
| Address2: | |||||||||
| City: | WPAFB | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454335529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9372579844 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/23/2005 | ||||||||
| LastUpdateDate: | 06/28/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 01060117A | IN | N | Allopathic & Osteopathic Physicians | General Practice | 207X00000X | 01060117A | IN | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.