Provider Demographics
NPI:1194933077
Name:YOUNG, ELEZABETH (MD)
Entity type:Individual
Prefix:
First Name:ELEZABETH
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4030 EASTON STATION
Mailing Address - Street 2:STE 200
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219
Mailing Address - Country:US
Mailing Address - Phone:614-759-6626
Mailing Address - Fax:614-759-8403
Practice Address - Street 1:4030 EASTON STATION
Practice Address - Street 2:200
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-7012
Practice Address - Country:US
Practice Address - Phone:614-759-6626
Practice Address - Fax:614-759-8403
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.090081207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology