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NPI Code Detail

MEDICARE: EDWIN S. DRAUGHON M.D.

MEDICARE: EDWIN S. DRAUGHON M.D.
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
1283Q00000XPsychiatric HospitalK5909TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801915996
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDWIN S. DRAUGHON M.D.
Provider Business Mailing Address
First Line : 4730 COLLEGE DR
Second Line :
City : VERNON
State : TX
Zip : 76384-4009
Country : US
Telephone Number : 940-552-4055
Fax Number :
Provider Business Practice Location Address
First Line : 4730 COLLEGE DR
Second Line :
City : VERNON
State : TX
Zip : 76384-4009
Country : US
Telephone Number : 940-552-4055
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2007
Last Update Date : 08/22/2008

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