Provider Demographics
NPI:1154603066
Name:YOUNG, PAUL ANTHONY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ANTHONY
Last Name:YOUNG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-7026
Mailing Address - Country:US
Mailing Address - Phone:801-616-5237
Mailing Address - Fax:801-616-5243
Practice Address - Street 1:850 S STATE ST
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84097-7026
Practice Address - Country:US
Practice Address - Phone:801-616-5237
Practice Address - Fax:801-616-5243
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5816944-1701183500000X
FLPS47314183500000X
CA65309183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist