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NPI Code Detail

MEDICARE: DR. ROBERT WILLIAM VAUGHN D.C.

MEDICARE: DR. ROBERT WILLIAM VAUGHN 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
1111N00000XChiropractor038-009135IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11026618OTHERILBLUE CROSS

General Provider Information

NPI Number : 1447297668
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT WILLIAM VAUGHN D.C.
Provider Business Mailing Address
First Line : 1502 W OTTAWA ST
Second Line : P.O. BOX 311
City : PAXTON
State : IL
Zip : 60957-4090
Country : US
Telephone Number : 217-379-3400
Fax Number : 217-379-3444
Provider Business Practice Location Address
First Line : 1502 W OTTAWA ST
Second Line :
City : PAXTON
State : IL
Zip : 60957-4090
Country : US
Telephone Number : 217-379-3400
Fax Number : 217-379-3444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2006
Last Update Date : 09/08/2014

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