Provider Demographics
NPI:1679015010
Name:VAUGHN MEDICAL CONSULTING
Entity Type:Organization
Organization Name:VAUGHN MEDICAL CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-376-3500
Mailing Address - Street 1:6110 MAIN ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-4033
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6110 MAIN ST
Practice Address - Street 2:SUITE D
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-4033
Practice Address - Country:US
Practice Address - Phone:504-376-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-16
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA292314207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty