Provider Demographics
NPI:1043599541
Name:VAUGHN FAMILY CARE LLC
Entity Type:Organization
Organization Name:VAUGHN FAMILY CARE LLC
Other - Org Name:VAUGHN URGENT CARE LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:THANG
Authorized Official - Middle Name:QUOC
Authorized Official - Last Name:AN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:334-514-1692
Mailing Address - Street 1:9540 WYNLAKES PL
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-8515
Mailing Address - Country:US
Mailing Address - Phone:334-395-9933
Mailing Address - Fax:334-395-9907
Practice Address - Street 1:9540 WYNLAKES PL
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117
Practice Address - Country:US
Practice Address - Phone:334-395-9933
Practice Address - Fax:334-395-9907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-15
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty