Provider Demographics
NPI:1194979427
Name:YOUNG, LYLE (MD)
Entity type:Individual
Prefix:DR
First Name:LYLE
Middle Name:
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1255 W RIO SALADO PKWY STE 107
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-2892
Mailing Address - Country:US
Mailing Address - Phone:480-962-0071
Mailing Address - Fax:480-962-0590
Practice Address - Street 1:1255 W RIO SALADO PKWY STE 107
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-2892
Practice Address - Country:US
Practice Address - Phone:480-962-0071
Practice Address - Fax:480-962-0590
Is Sole Proprietor?:No
Enumeration Date:2008-11-13
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA068125207XS0117X
AZ47545207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine