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NPI Code Detail

MEDICARE: GARRETT VAUGHN PA-C

MEDICARE: GARRETT VAUGHN PA-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
1363A00000XPhysician Assistant10498AZ
2363AM0700XMedical Physician Assistant10498AZ

General Provider Information

NPI Number : 1578396784
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARRETT VAUGHN PA-C
Provider Business Mailing Address
First Line : 7051 E KESSLER AVE
Second Line :
City : MESA
State : AZ
Zip : 85209-4082
Country : US
Telephone Number : 480-228-3985
Fax Number :
Provider Business Practice Location Address
First Line : 2400 S AVENUE A
Second Line :
City : YUMA
State : AZ
Zip : 85364-7170
Country : US
Telephone Number : 928-336-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2024
Last Update Date : 03/19/2026

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Directions to “ GARRETT VAUGHN PA-C” Practice Location

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