Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP1101X | Primary Podiatric Medicine | 213 | AL |
Y | 213ES0131X | Foot Surgery | 213 | AL |
NPI | 1275686305 |
---|---|
Provider Name | Dr. Hadryan H Vaughn |
First Address | Montgomery, AL 36106-3078 |
Second Address | Montgomery, AL 36106-3078 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2007 |
Last Update Date | 10/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U77131 | (02) | AL |