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General NPI Number Information
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NPI Number | 1063673788
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Entity Type | Organization
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Legal Business Name | VAUGHN EYECARE, LLC
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Dates
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Enumeration Date | 06/25/2008
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 567 S COUNTY TRL SUITE 305
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City | EXETER
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State | RI
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Zip | 02822-3422
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Country | US
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Telephone | 401-295-5955
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Fax | 401-295-4955
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Provider Business Mailing Address
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Address Line | 567 S COUNTY TRL SUITE 305
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City | EXETER
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State | RI
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Zip | 02822-3422
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Country | US
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Telephone | 401-295-5955
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Fax | 401-295-4955
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. ROBERT G. VAUGHN JR.
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Credential | O.D.
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Telephone | 401-295-5955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | ODTG00525
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License Number State | RI
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