Provider Demographics
NPI:1982236550
Name:YOUNG, STEPHEN (PA-C)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:YOUNG
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1906 INVERNESS BLVD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-2892
Mailing Address - Country:US
Mailing Address - Phone:512-828-2209
Mailing Address - Fax:
Practice Address - Street 1:1 AIRPORT WAY
Practice Address - Street 2:
Practice Address - City:PRUDHOE BAY
Practice Address - State:AK
Practice Address - Zip Code:99734
Practice Address - Country:US
Practice Address - Phone:907-685-1725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-11
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0006931363A00000X
TXPA13250363A00000X
AK212104363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant