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General NPI Number Information
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NPI Number | 1114447547
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Entity Type | Organization
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Legal Business Name | DR. ROBERT VAUGHN LLC
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Dates
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Enumeration Date | 06/27/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1168 WARWICK AVE
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City | WARWICK
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State | RI
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Zip | 02888-4106
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Country | US
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Telephone | 401-864-6354
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Fax | 401-295-4955
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Provider Business Mailing Address
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Address Line | 1168 WARWICK AVE
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City | WARWICK
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State | RI
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Zip | 02888-4106
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Country | US
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Telephone | 401-864-6354
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Fax | 401-295-4955
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. ROBERT VAUGHN
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Credential | OD
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Telephone | 401-864-6354
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 525
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License Number State | RI
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