Provider Demographics
NPI:1598730202
Name:VAUGHAN, ERIC W (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:W
Last Name:VAUGHAN
Suffix:
Gender:M
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:PO BOX 478
Mailing Address - Street 2:
Mailing Address - City:ANAHOLA
Mailing Address - State:HI
Mailing Address - Zip Code:96703-0478
Mailing Address - Country:US
Mailing Address - Phone:913-953-6551
Mailing Address - Fax:
Practice Address - Street 1:3-3420 KUHIO HWY LIHUE
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1099
Practice Address - Country:US
Practice Address - Phone:913-588-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-21810207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine