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General NPI Number Information
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NPI Number | 1336335801
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Entity Type | Organization
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Legal Business Name | DR. SID C. VAUGHT, P.C.
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 09/19/2007
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Provider Practice Location Address
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Address Line | 731 E STATE HIGHWAY 152
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City | MUSTANG
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State | OK
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Zip | 73064-4520
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Country | US
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Telephone | 405-376-4575
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Fax | 405-376-4576
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Provider Business Mailing Address
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Address Line | 731 E STATE HIGHWAY 152 PO BOX 666
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City | MUSTANG
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State | OK
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Zip | 73064-4520
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Country | US
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Telephone | 405-376-4575
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Fax | 405-376-4576
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. SIDNEY CHARLES VAUGHT
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Credential | DC
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Telephone | 405-376-4575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2003
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License Number State | OK
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