Vaughan, Wallace Carroll

Vaughan, Wallace Carroll is an individual health care provider with primary practice located at 6980 Winton Blount Blvd , Montgomery AL 36117-3556. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Vaughan, Wallace Carroll can be contacted via phone (334) 277-0484.

Contact Information

Primary practice address
6980 Winton Blount Blvd Montgomery AL 36117-3556
Phone: (334) 277-0484
Fax: (334) 272-8877
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 13438 Alabama

Profile Details

NPI number 1104906510
LBN Legal business name Vaughan, Wallace Carroll
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2006
Last updated Nov 13th, 2015 - about 9 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 1104906510 NPPES
Alabama MEDICAID 528701330
Alabama Other 17143
Alabama Other 040002702

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