Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 856 | NV |
NPI | 1003893835 |
---|---|
Provider Name | Scott Young |
First Address | Las Vegas, NV 89108-4578 |
Second Address | Las Vegas, NV 89128-9028 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2005 |
Last Update Date | 20/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002019972 | (05) | NV |
F40858 | (02) | NV |
V115433 | (02) | NV |