Healthcare Provider Details

I. General information

NPI: 1902857444
Provider Name (Legal Business Name): GAYLON VAUGHN OWENS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 VANDERBILT PARK DR STE 100
ASHEVILLE NC
28803-2476
US

IV. Provider business mailing address

4 VANDERBILT PARK DR STE 100
ASHEVILLE NC
28803-2476
US

V. Phone/Fax

Practice location:
  • Phone: 828-258-0397
  • Fax: 828-258-3390
Mailing address:
  • Phone: 828-258-0397
  • Fax: 828-258-3390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number200900521
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number200900521
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: