Provider Demographics
NPI:1336709492
Name:YOUNG, KATHRYN G (MD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:G
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 749112
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-9112
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:650 PETER JEFFERSON PKWY STE 290
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8848
Practice Address - Country:US
Practice Address - Phone:434-297-7140
Practice Address - Fax:434-297-7235
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2024-10-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101276803207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine