Young, David Russell
Young, David Russell is an individual health care provider with primary practice located at 970 Lakeland Dr Suite 61, Jackson MS 39216-4635. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Young, David Russell can be contacted via phone (601) 982-7850.Contact Information
Primary practice address
970 Lakeland Dr Suite 61
Jackson MS 39216-4635
Phone: (601) 982-7850
Fax: (601) 718-5145
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 13925 | Mississippi |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 13925 | Mississippi |
Profile Details
| NPI number | 1366487365 |
|---|---|
| LBN Legal business name | Young, David Russell |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 17th, 2006 |
| Last updated | Mar 11th, 2025 - about last year |
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 | 1366487365 | NPPES |
| Mississippi | MEDICAID | 00119854 |
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