Basic Information
| Provider Information | |||||||||
| NPI: | 1962760546 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YOUNT | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | ROBERT | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 201 CASSELL DR | ||||||||
| Address2: | |||||||||
| City: | KINGSPORT | ||||||||
| State: | TN | ||||||||
| PostalCode: | 376603747 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4232459600 | ||||||||
| FaxNumber: | 4232459631 | ||||||||
| Practice Location | |||||||||
| Address1: | 201 CASSELL DR | ||||||||
| Address2: | |||||||||
| City: | KINGSPORT | ||||||||
| State: | TN | ||||||||
| PostalCode: | 376603747 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4232459600 | ||||||||
| FaxNumber: | 4232459631 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2012 | ||||||||
| LastUpdateDate: | 11/23/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 2739 | TN | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 0102204177 | VA | N | Allopathic & Osteopathic Physicians | Family Medicine | 208M00000X | 2739 | TN | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | Q014780 | 05 | TN | MEDICAID |