MEDICARE: DR. JOHN B. VAUGHAN D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	739	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	35370	OTHER	MA	HARVARDPILGRIM
2	1331266001	OTHER	MA	CIGNA
3	VA Y35528	OTHER	MA	BLUECROSS/BLUESHIELD

General Provider Information

NPI Number	:	1174530539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN B. VAUGHAN D.C.

Provider Business Mailing Address
First Line	:	589 DARTMOUTH ST
Second Line	:
City	:	S DARTMOUTH
State	:	MA
Zip	:	02748-2516
Country	:	US
Telephone Number	:	508-997-5636
Fax Number	:	508-717-6267

Provider Business Practice Location Address
First Line	:	589 DARTMOUTH ST
Second Line	:
City	:	S DARTMOUTH
State	:	MA
Zip	:	02748-2516
Country	:	US
Telephone Number	:	508-997-5636
Fax Number	:	508-717-6267

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	07/08/2007

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