Individual
MARTIN VAUGHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2620 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3396
(573) 785-7721
Mailing address
280 CR 782, JONESBORO, AR 72401
(870) 972-9454
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2005030753
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
C001525
AR
Other
Enumeration date
05/21/2007
Last updated
01/15/2026
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