MEDICARE: MR. VAUGHN R MEINERS JR. 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	207Q00000X	Family Medicine Physician	ME 90786	FL
2	207Q00000X	Family Medicine Physician	MD200094	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1237391	OTHER	FL	CIGNA
2	303300	OTHER	FL	HEALTHEASE
3	ME90786	OTHER	FL	FLORIDA DEPARTMENT OF HEALTH LICENSE
4	298355	OTHER	FL	AVMED
5	28691	OTHER	FL	BCBS
6	7948774	OTHER	FL	AETNA

General Provider Information

NPI Number	:	1710961586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. VAUGHN R MEINERS JR. MD

Provider Business Mailing Address
First Line	:	7049 PERKINS RD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-4320
Country	:	US
Telephone Number	:	225-706-2166
Fax Number	:	225-706-3061

Provider Business Practice Location Address
First Line	:	7049 PERKINS RD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-4320
Country	:	US
Telephone Number	:	225-706-2166
Fax Number	:	225-706-3061

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

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	03/13/2017

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