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NPI Code Detail

MEDICARE: DR. PATRICK BLAKE VAUGHN DO

MEDICARE: DR. PATRICK BLAKE VAUGHN DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1225976947
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PATRICK BLAKE VAUGHN DO
Provider Business Mailing Address
First Line : 2000 CHURCH STREET NASHVILLE TN 37236
Second Line : UT IM RESIDENCY
City : NASHVILLE
State : TN
Zip : 37236-0001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 920 MADISON AVE STE 447
Second Line :
City : MEMPHIS
State : TN
Zip : 38103-3438
Country : US
Telephone Number : 615-284-3387
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2026
Last Update Date : 03/23/2026

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