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NPI Code Detail

MEDICARE: STEVEN C VAUGHAN DPH

MEDICARE: STEVEN C VAUGHAN DPH
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
1183500000XPharmacist10525OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
110525OTHEROKSTATE BOARD OF PHARMACY

General Provider Information

NPI Number : 1528041340
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN C VAUGHAN DPH
Provider Business Mailing Address
First Line : 42494 E COUNTY ROAD 1510
Second Line :
City : BLAIR
State : OK
Zip : 73526-5010
Country : US
Telephone Number : 580-563-2527
Fax Number : 580-379-5709
Provider Business Practice Location Address
First Line : 1200 E PECAN ST
Second Line :
City : ALTUS
State : OK
Zip : 73521-6141
Country : US
Telephone Number : 580-379-5706
Fax Number : 580-379-5709
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2005
Last Update Date : 05/07/2012

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Directions to “ STEVEN C VAUGHAN DPH” Practice Location

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