Staci R Young MD PC

NPI #1972675106 in Edwardsville, Illinois

Provider Information

NPI Number: 1972675106
Entity Type: Organization
Organization Name: Staci R Young MD PC
Primary Specialty: Pediatrics
Enumeration Date: Nov 14, 2006
Last Updated: Feb 4, 2008

Practice Location

Address: 3 SUNSET HILLS PROFESSIONAL CTR STE D
City: Edwardsville
State: Illinois
ZIP Code: 62025-3760
Phone: (618) 655-0015

Authorized Official

Name: STACI R YOUNG, MD
Title: OWNER
Phone: (618) 655-0015

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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