Jeff P Young MD PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

K5033 Issued in TX

Legal business name

JEFF P YOUNG MD PA

Practice address

2011 Moores LN
Texarkana, TX 75503-1841

Phone

(903) 792-2777

Fax

(903) 794-6728

NPI assigned

Oct 9, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jeff P Young, M.D.

Title

Owner

Phone

(903) 792-2777

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Garrett W Camp, FNP-C

  • Nurse Practitioner
  • Texarkana, TX
  • NPI 1649756198

  Dermatology

  Medicare reassignment NPD
• Jeffrey Paul Young, M.D.

  • Dermatology Physician
  • Texarkana, TX
  • NPI 1215934062
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1255046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255046400000",
    "number": "1184959082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 MOORES LN",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755031841",
            "telephone_number": "903-792-2777",
            "fax_number": "903-794-6728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 MOORES LN",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755031841",
            "telephone_number": "903-792-2777",
            "fax_number": "903-794-6728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFF P YOUNG MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-09",
        "last_updated": "2009-10-09",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "JEFF",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-792-2777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "TX",
            "license": "K5033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sudheer M Jayaprabhu, MD
• Alan B Jean, M.D.
• James L Jean, M.D.
• Jeanne a. Field Miller D/B/a Summerhill Counseling Center
• Jeanne a. Field Miller Doing Business As Summerhill Counseling Center
• Jeffory F Thomas, MD PA
• Jeffrey D Decaprio MD PA
• Jeffrey L. Martin DDS,P.a.
• Kacey D Jenkins
• Kendall Jenkins

• Dermatology Physician in Texarkana, TX
• Providers in Texarkana, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.