Provider Demographics
NPI:1457327587
Name:VAUGHTERS, RAY BAUER III (MD)
Entity Type:Individual
Prefix:MR
First Name:RAY
Middle Name:BAUER
Last Name:VAUGHTERS
Suffix:III
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 1132
Mailing Address - Street 2:R BAUER VAUGHTERS III MD INC
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29802-1132
Mailing Address - Country:US
Mailing Address - Phone:803-648-3130
Mailing Address - Fax:803-502-1103
Practice Address - Street 1:526 RICHLAND AVE W
Practice Address - Street 2:R BAUER VAUGHTERS III MD INC
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801
Practice Address - Country:US
Practice Address - Phone:803-648-3130
Practice Address - Fax:803-502-1103
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22809207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC228097Medicaid
H14116Medicare UPIN