DR. JEFFREY PAUL YOUNG (NPI# 1215934062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215934062 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY PAUL YOUNG |
| Credential | M.D. |
| Practice Address |
2011 Moores Ln Texarkana TX 75503-1841 |
| Practice Telephone | 9037922777 |
| Practice Fax Number | 9037946728 |
| Mailing Telephone | 9037922777 |
| Mailing Fax Number | 9037946728 |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2009-09-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 20679 | OK | Other Service Providers |
| N | 174400000X | Specialist | E2607 | AR | Other Service Providers |
| Y | 174400000X | Specialist | K5033 | TX | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RR MEDICARE | 070012558 | 01 | |
| TX | 031075701 | 05 | |
| AR | 134647001 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043784291 | Jeffrey E Young | Pharmacist | 1095 Tamiami Trl N Ste B, Nokomis, FL 34275-2117 | 2019-01-21 |
| 1356811392 | Jeffrey Allen Young | Chiropractor | 4266 Cottage Hill Rd, Ste 4, Mobile, AL 36609-4277 | 2018-12-03 |
| 1275069478 | Jeffrey Joe Young | PACE Provider Organization | 2129 Green Lee Lane, Dickinson, TX 77539-5152 | 2017-05-08 |
| 1770883449 | Jeffrey Ogden Young | Technician/Technologist | 34 Margaret Dr, Roosevelt, NY 11575-1535 | 2010-10-28 |
| 1881878940 | Jeffrey Alan Young | Technician, Other | 300 North Fill Pier, Commanding Officer, Cordova, AK 99574-0300 | 2007-12-26 |
| 1578742755 | Jeffrey A Young | Dentist | 29001 Cedar Rd Ste 660, Lyndhurst, OH 44124-4041 | 2007-10-24 |
| 1760519045 | Jeffrey A Young | Chiropractor | 17425 Stuebner Airline Rd Ste C, Spring, TX 77379-3708 | 2007-02-27 |
| 1578609681 | Jeffrey Scott Young | Social Worker | 6539 Anthony Dr Ste A, Victor, NY 14564-1400 | 2007-01-29 |
| 1659470763 | Jeffrey Stephen Young | Ophthalmology | W180 N8000 Town Hall Road, Menomonee Falls, WI 53051 | 2006-09-22 |
| 1477561207 | Jeffrey A. Young | Radiology | 111 Greely Rd, Cumberland, ME 04021-3800 | 2006-08-04 |
| Street Address |
2011 MOORES LN |
| City | TEXARKANA |
| State | TX |
| Zip Code | 75503-1841 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063419307 | Hayden H Franks | Specialist | 2011 Moores Ln, Texarkana, TX 75503-1841 | 2005-07-01 |
| 1649756198 | Garrett W Camp | Dermatology | 2011 Moores Ln, Texarkana, TX 75503-1841 | 2018-07-18 |
| 1205296480 | Amber Kasey Vaughter | Nurse Practitioner | 2011 Moores Ln, Texarkana, TX 75503-1841 | 2016-03-01 |
| 1245690726 | Dermatology Associates LLP | Dermatology | 2011 Moores Ln, Texarkana, TX 75503-1841 | 2016-02-26 |
| 1154656056 | Hayden H Franks Md Pa | Dermatology | 2011 Moores Ln, Texarkana, TX 75503-1841 | 2009-10-09 |
| 1184959082 | Jeff P Young Md Pa | Dermatology | 2011 Moores Ln, Texarkana, TX 75503-1841 | 2009-10-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770049397 | Jeffery Nash | Nurse Practitioner | #4 Valley View Circle, Texarkana, TX 75503 | 2019-02-19 |
| 1821583501 | Brandy D Acker | Psychologist | 3615 Richmond Rd, Texarkana, TX 75503 | 2018-06-26 |
| 1366935066 | Samantha Lee Harris | Nurse Practitioner | 4116 Mcknight Rd, Texarkana, TX 75503 | 2018-06-07 |
| 1811416910 | Heather Alison Gerber | Nurse Practitioner | 5903 Brenda Street, Texarkana, TX 75503 | 2017-09-11 |
| 1952838682 | John Kyle Abney | Counselor | 4134 Mcknight Rd, Texarkana, TX 75503 | 2017-05-12 |
| 1699151514 | Piney Woods Er IIi LLC | Clinic/Center | 4102 Gibson Lane, Texarkana, TX 75503 | 2015-08-03 |
| 1609282433 | Colby Rebecca Pair | Physician Assistant | 2604 St. Michael Dr., Suite 310, Texarkana, TX 75503 | 2014-07-01 |
| 1265842496 | Healthcare Express, LLP | Clinic/Center | 3513 Richmond Rd, Texarkana, TX 75503 | 2014-04-28 |
| 1134540628 | Eagle Dental Center of Texarkana Pllc | Dentist | 4009 Moores Ln, Texarkana, TX 75503 | 2013-12-30 |
| 1326481664 | Juancarlo S. Pascual | Family Medicine | 604 St. Michael Dr, Suite 340, Texarkana, TX 75503 | 2013-04-16 |
| Find all providers in zip 75503 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619142072 | George F. Moricz, M.d., P.a. | Specialist | 1002 Texas Blvd Ste 301, Texarkana, TX 75501-5118 | 2008-04-28 |
| 1154474674 | The Specialists for Women of Texarkana Pllc | Specialist | 1002 Texas Blvd Ste 200, Texarkana, TX 75501-5133 | 2007-01-19 |
| 1568419984 | Texarkana Eye Group Plc | Specialist | 3211 Sugar Hill Rd, Texarkana, AR 71854-9219 | 2006-05-30 |
| 1871546051 | Roger Dale House | Specialist | 2401 Summerhill Rd, Suite A, Texarkana, TX 75501-3570 | 2006-05-18 |
| 1104884386 | Mark A Wren | Specialist | 4613 Parkway Dr Ste 1, Texarkana, AR 71854-1142 | 2006-05-03 |
| 1962490458 | Charles Edward Hollingsworth II | Specialist | 5420 Medical Parkway Dr, Texarkana, TX 75503-4622 | 2005-10-10 |
| 1407841695 | Russ Todd Nelson | Specialist | 4303 Texas Blvd, Ste 8, Texarkana, TX 75503-3097 | 2005-09-14 |
| 1063419307 | Hayden H Franks | Specialist | 2011 Moores Ln, Texarkana, TX 75503-1841 | 2005-07-01 |
| 1063419646 | Stanley Cleveland Knowles | Specialist | 1920 Moores Ln, Suite A, Texarkana, TX 75503-4664 | 2005-06-28 |
| 1649275496 | David Lee Carlisle | Specialist | 1000 Pine St, Texarkana, TX 75501-5100 | 2005-06-17 |
| Find all providers in TEXARKANA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.