Provider Demographics
NPI:1386602779
Name:YOUNG, AMY B (MD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:B
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:110 MED TECH PKWY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-4004
Mailing Address - Country:US
Mailing Address - Phone:423-929-2111
Mailing Address - Fax:423-929-0497
Practice Address - Street 1:110 MED TECH PKWY
Practice Address - Street 2:SUITE 1
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-4004
Practice Address - Country:US
Practice Address - Phone:423-929-2111
Practice Address - Fax:423-929-0497
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2019-01-04
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Provider Licenses
StateLicense IDTaxonomies
TNMD24809207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3078562Medicaid
TN180016466OtherRAILROAD MEDICARE
TN180016466OtherRAILROAD MEDICARE
TNF69321Medicare UPIN
TN3078562Medicare PIN