Provider Demographics
NPI:1043356017
Name:VAUGHAN, ELIZABETH RANKIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:RANKIN
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 W WENDOVER AVE
Mailing Address - Street 2:STE A
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-8123
Mailing Address - Country:US
Mailing Address - Phone:336-808-3627
Mailing Address - Fax:336-808-3628
Practice Address - Street 1:1301 W WENDOVER AVE
Practice Address - Street 2:SUITE A
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-8125
Practice Address - Country:US
Practice Address - Phone:336-808-3627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC27863207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCB10390Medicare UPIN