| Jordan T Young Md, Pa | |
|
9332 State Road 54 Ste 202 Trinity FL 34655-1810 | |
| (727) 597-4441 | |
| (727) 597-4445 |
| Full Name | Jordan T Young Md, Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 9332 State Road 54 Ste 202, Trinity, Florida |
| Authorized Official Name and Position | Jordan Terrell Young (PHYSICIAN) |
| Authorized Official Contact | 2522586375 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jordan T Young Md, Pa 9332 State Road 54 Ste 202 Trinity FL 34655-1810 Ph: (727) 597-4441 | Jordan T Young Md, Pa 9332 State Road 54 Ste 202 Trinity FL 34655-1810 Ph: (727) 597-4441 |
| NPI Number | 1679832737 |
|---|---|
| Provider Enumeration Date | 05/10/2012 |
| Last Update Date | 05/23/2024 |
| Medicare PECOS PAC ID | 6406012475 |
|---|---|
| Medicare Enrollment ID | O20120718000746 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679832737 | NPI | - | NPPES |
| 009376200 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | ME112761 (Florida) | Secondary |
| Provider Name | Jordan T Young |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457371684 PECOS PAC ID: 8325128275 Enrollment ID: I20120726000642 |
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