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1376520049

NPI Code Detail

MEDICARE: VAUGHAN RICHARD BOWEN MD

MEDICARE: VAUGHAN RICHARD BOWEN MD

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	207Y00000X	Otolaryngology Physician	20580	NE
2	207Y00000X	Otolaryngology Physician	2020030112	MO
3	207Y00000X	Otolaryngology Physician	11214	SD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	03182	OTHER	NE	BCBSNE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376520049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VAUGHAN RICHARD BOWEN MD

Provider Business Mailing Address
First Line	:	4447 S CANYON RD STE 6
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57702-1889
Country	:	US
Telephone Number	:	605-716-0548
Fax Number	:	605-716-0447

Provider Business Practice Location Address
First Line	:	4447 S CANYON RD STE 6
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57702-1889
Country	:	US
Telephone Number	:	605-716-0548
Fax Number	:	605-716-0447

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

Provider Enumeration Date	:	12/23/2005
Last Update Date	:	11/02/2022

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1033545082 — MR. CRAIG ALLEN MULLINS M.A., L.P.C.-MH
Practice Location Address:

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1154703817 — MRS. ERICKA L. PRIVITT N.P.
Practice Location Address:

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57702-1889

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Practice Location Address:

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57702-1889

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1548804990 — CHELSEY KRISTYN WATSON CNP
Practice Location Address:

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Directions to “ VAUGHAN RICHARD BOWEN MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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