Healthcare Provider Details

I. General information

NPI: 1942235429
Provider Name (Legal Business Name): VAUGHAN ROBERT CIPPERLY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 04/22/2021
Certification Date: 04/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 4TH ST SW
MASON CITY IA
50401-2800
US

IV. Provider business mailing address

1000 4TH ST SW
MASON CITY IA
50401-2800
US

V. Phone/Fax

Practice location:
  • Phone: 641-428-6300
  • Fax: 641-428-6374
Mailing address:
  • Phone: 641-428-6300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number38639
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD-20983
License Number StateHI
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number48051
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: