Provider Demographics
NPI:1518050418
Name:CAVANAH, DAVID YOUNG (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:YOUNG
Last Name:CAVANAH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 235
Mailing Address - Street 2:2411 OAK HEIGHT RD
Mailing Address - City:DIXON
Mailing Address - State:KY
Mailing Address - Zip Code:42409
Mailing Address - Country:US
Mailing Address - Phone:270-639-5701
Mailing Address - Fax:
Practice Address - Street 1:2411 OAK HEIGHT RD
Practice Address - Street 2:
Practice Address - City:DIXON
Practice Address - State:KY
Practice Address - Zip Code:42409
Practice Address - Country:US
Practice Address - Phone:270-639-5701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3192111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
6027301Medicare UPIN