Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 3898 | AZ |
NPI | 1073832515 |
---|---|
Provider Name | Dr. Cecil Cyrus Vaughn II |
First Address | Phoenix, AZ 85016-4527 |
Second Address | Phoenix, AZ 85016-4527 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2010 |
Last Update Date | 24/05/2010 |