Young, Mark R

Young, Mark R is an individual health care provider with primary practice located at 1504 N 1St St , Indianola IA 50125-3702. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Young, Mark R can be contacted via phone (515) 961-3700.

Contact Information

Primary practice address
1504 N 1St St Indianola IA 50125-3702
Fax: (515) 962-0160
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 24278 Iowa

Profile Details

NPI number 1972580066
LBN Legal business name Young, Mark R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 29th, 2005
Last updated Jul 9th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972580066 NPPES
Iowa MEDICAID 2221515
Iowa MEDICAID 1221515
Iowa MEDICAID 0221515
Iowa MEDICAID 4221515

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