Blackburn, Vaughn Daniel

Blackburn, Vaughn Daniel is an individual health care provider with primary practice located at 5 W Main St , Amelia OH 45102-1924. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Blackburn, Vaughn Daniel can be contacted via phone (513) 753-0500.

Contact Information

Primary practice address
5 W Main St Amelia OH 45102-1924
Phone: (513) 753-0500
Fax: (513) 986-0218
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 36003708 Ohio

Profile Details

NPI number 1386925170
LBN Legal business name Blackburn, Vaughn Daniel
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 7th, 2011
Last updated Feb 12th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386925170 NPPES
Ohio MEDICAID 0119172
Ohio MEDICAID 7100441710
Ohio MEDICAID 201371230

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