Provider Demographics
NPI:1902628803
Name:YOUNGER, WILLIAM R III (INSURANCED PRODUCER)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:R
Last Name:YOUNGER
Suffix:III
Gender:M
Credentials:INSURANCED PRODUCER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 SLOAN RD
Mailing Address - Street 2:
Mailing Address - City:LYMAN
Mailing Address - State:SC
Mailing Address - Zip Code:29365-9747
Mailing Address - Country:US
Mailing Address - Phone:864-520-6502
Mailing Address - Fax:
Practice Address - Street 1:720 SLOAN RD
Practice Address - Street 2:
Practice Address - City:LYMAN
Practice Address - State:SC
Practice Address - Zip Code:29365-9747
Practice Address - Country:US
Practice Address - Phone:864-520-6502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21058405305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC21058405OtherINSURANCE PROVIDER