Provider Demographics
NPI:1659761732
Name:VAUGHT FAMILY EYECARE, LLC
Entity Type:Organization
Organization Name:VAUGHT FAMILY EYECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUGHT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:812-844-0316
Mailing Address - Street 1:105 QUEENS CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:IN
Mailing Address - Zip Code:46131-8927
Mailing Address - Country:US
Mailing Address - Phone:812-844-0316
Mailing Address - Fax:
Practice Address - Street 1:1037 W JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131-2123
Practice Address - Country:US
Practice Address - Phone:317-736-7722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-28
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003592152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty