Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 224438 | NC |
N | 207QA0401X | Family Doctor - Addiction Medicine | 35 045937 | OH |
NPI | 1194755207 |
---|---|
Provider Name | Dr. Thomas Robert Vajen |
First Address | Lafayette, LA 70508-3870 |
Second Address | Bryson City, NC 28713-4200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 31/10/2018 |