MEDICARE: TROY VAUGHN DPT

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	225100000X	Physical Therapist	PTH10710	AL
2	225100000X	Physical Therapist	2-1087	AL

General Provider Information

NPI Number	:	1982364386
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TROY VAUGHN DPT

Provider Business Mailing Address
First Line	:	2823 GREYSTONE COMMERCIAL BLVD
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-2660
Country	:	US
Telephone Number	:	205-745-3660
Fax Number	:

Provider Business Practice Location Address
First Line	:	1280 COLUMBIANA RD STE 160
Second Line	:
City	:	VESTAVIA HILLS
State	:	AL
Zip	:	35216-1604
Country	:	US
Telephone Number	:	205-968-1283
Fax Number	:

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

Provider Enumeration Date	:	12/27/2021
Last Update Date	:	07/25/2024

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