Individual
DR. MARK VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 N COLLEGE AVE, FAYETTEVILLE, AR 72703-1944
(479) 433-4301
Mailing address
1100 N COLLEGE AVE, FAYETTEVILLE, AR 72703-1944
(479) 443-4301
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E-8822
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124250741
NPI
CO
01
—
45945
STATE LICENSE
CO
Enumeration date
08/14/2009
Last updated
09/22/2022
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