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NPI Code Detail

MEDICARE: DR. GARLAND THOMAS VAUGHN

MEDICARE: DR. GARLAND THOMAS VAUGHN
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
1101YP2500XProfessional Counselor2399SC

General Provider Information

NPI Number : 1336253715
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GARLAND THOMAS VAUGHN
Provider Business Mailing Address
First Line : 7 FOXCROFT LN
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29577-8051
Country : US
Telephone Number : 843-340-0991
Fax Number : 843-448-9875
Provider Business Practice Location Address
First Line : 901 N KINGS HWY
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29577-3722
Country : US
Telephone Number : 843-448-4820
Fax Number : 843-448-9875
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2006
Last Update Date : 07/08/2007

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Directions to “ DR. GARLAND THOMAS VAUGHN ” Practice Location

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