Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0117X | Orthopaedic Spine Surgeon | 068125 | GA |
Y | 207XS0117X | Orthopaedic Spine Surgeon | 47545 | AZ |
NPI | 1194979427 |
---|---|
Provider Name | Dr. Lyle Young |
First Address | Tempe, AZ 85281-2892 |
Second Address | Tempe, AZ 85281-2892 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2008 |
Last Update Date | 04/02/2019 |