Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | MD204270 | LA |
NPI | 1033736343 |
---|---|
Provider Name | David S Vaughan |
First Address | Metairie, LA 70002-5798 |
Second Address | Metairie, LA 70002-5798 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2020 |
Last Update Date | 02/07/2020 |