Provider Demographics
NPI:1710961586
Name:MEINERS, VAUGHN R JR (MD)
Entity Type:Individual
Prefix:MR
First Name:VAUGHN
Middle Name:R
Last Name:MEINERS
Suffix:JR
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 1:7049 PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4320
Mailing Address - Country:US
Mailing Address - Phone:225-706-2166
Mailing Address - Fax:225-706-3061
Practice Address - Street 1:7049 PERKINS RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4320
Practice Address - Country:US
Practice Address - Phone:225-706-2166
Practice Address - Fax:225-706-3061
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 90786207Q00000X
LAMD200094207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1237391OtherCIGNA
FL303300OtherHEALTHEASE
FLME90786OtherFLORIDA DEPARTMENT OF HEALTH LICENSE
FL298355OtherAVMED
FL28691OtherBCBS
FL7948774OtherAETNA
FL28691OtherBCBS
FLP00321214Medicare PIN
FL303300OtherHEALTHEASE