Provider Demographics
NPI:1871634667
Name:VAUGHN, MICHAEL ANDREW (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANDREW
Last Name:VAUGHN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 COMMERCIAL DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3606
Mailing Address - Country:US
Mailing Address - Phone:912-356-0031
Mailing Address - Fax:912-356-5471
Practice Address - Street 1:345 COMMERCIAL DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3606
Practice Address - Country:US
Practice Address - Phone:912-356-0031
Practice Address - Fax:912-356-5471
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA4721111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000519109AMedicaid
GAU11765Medicare UPIN
GA35ZCBQQMedicare ID - Type Unspecified