NPI 1043380819

Michael Owen Young, OD

Practitioner Optometrist Fort Wayne, IN

Practice location

Address: 6424 W Jefferson Blvd Suite a, Fort Wayne, IN 46804-6204
Phone: (260) 436-7530
Fax: (260) 436-2698

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 18002134A (IN)

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Registry record

NPI: 1043380819
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Nov 2006
Record last updated: 27 Nov 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.