Vaughn, Gary Jesse

Vaughn, Gary Jesse is an individual health care provider with primary practice located at 516 E Nizhoni Blvd , Gallup NM 87301. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine. Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine is his primary health care specialty. Vaughn, Gary Jesse can be contacted via phone (505) 722-1000.

Contact Information

Primary practice address
516 E Nizhoni Blvd Gallup NM 87301
Phone: (505) 722-1000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X M9151 Idaho
Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine 207QH0002X M-9151 Idaho

Profile Details

NPI number 1972546604
LBN Legal business name Vaughn, Gary Jesse
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2006
Last updated Jul 23rd, 2018 - about 8 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 1972546604 NPPES
New Mexico MEDICAID 14607531

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