Provider Demographics
NPI:1780813196
Name:VAUGHT, HOLLY JEAN (OD)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:JEAN
Last Name:VAUGHT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:HOLLY
Other - Middle Name:JEAN
Other - Last Name:ROWLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
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 1:1040 W JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131-2124
Practice Address - Country:US
Practice Address - Phone:317-736-7722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003592A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist