Provider Demographics
NPI:1447473962
Name:YOUNG, BROOKS A (DPM)
Entity type:Individual
Prefix:DR
First Name:BROOKS
Middle Name:A
Last Name:YOUNG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9300 MEADOW VIEW DR
Mailing Address - Street 2:STE 101
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66227-7288
Mailing Address - Country:US
Mailing Address - Phone:253-951-6377
Mailing Address - Fax:
Practice Address - Street 1:407 S CLAIRBORNE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1723
Practice Address - Country:US
Practice Address - Phone:913-764-3120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO00000787213ES0103X
MO2008003822213ES0103X
KS12-00368213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery