Provider Demographics
NPI:1174798227
Name:YOUNG, COURTNEY RENEE (MD)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:RENEE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:697 THOMAS LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3931
Mailing Address - Country:US
Mailing Address - Phone:614-566-4398
Mailing Address - Fax:614-566-6843
Practice Address - Street 1:216 TRACE DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-4151
Practice Address - Country:US
Practice Address - Phone:740-654-6300
Practice Address - Fax:740-654-0106
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.089982207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2832500Medicaid
OHYO424571Medicare PIN