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NPI Code Detail

MEDICARE: DR. ANDREW JOSEPH VAUGHAN D.O.

MEDICARE: DR. ANDREW JOSEPH VAUGHAN D.O.
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
1208600000XSurgery Physician5101022993MI
2208600000XSurgery Physician5101026883MI

General Provider Information

NPI Number : 1932634607
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREW JOSEPH VAUGHAN D.O.
Provider Business Mailing Address
First Line : 1234 NAPIER AVE
Second Line :
City : SAINT JOSEPH
State : MI
Zip : 49085-2112
Country : US
Telephone Number : 269-429-0900
Fax Number :
Provider Business Practice Location Address
First Line : 1234 NAPIER AVE
Second Line :
City : SAINT JOSEPH
State : MI
Zip : 49085-2112
Country : US
Telephone Number : 269-429-0900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2017
Last Update Date : 04/23/2026

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