MEDICARE: ARIZONA VASCULAR SURGERY CONSULTANTS

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
1	2086S0129X	Vascular Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881624732
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARIZONA VASCULAR SURGERY CONSULTANTS

Provider Business Mailing Address
First Line	:	2204 S DOBSON RD
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85202-6457
Country	:	US
Telephone Number	:	480-890-0280
Fax Number	:

Provider Business Practice Location Address
First Line	:	2204 S DOBSON RD
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85202-6457
Country	:	US
Telephone Number	:	480-890-0280
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. PAUL L VAUGHN
Credential	:	MD
Telephone Number	:	480-890-0280

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	12/20/2007

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