Individual
DR. VAUGHN H MANCHA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17326 BURWICK LOOP, FAIRHOPE, AL 36532
(334) 300-2511
(334) 265-0945
Mailing address
17326 BURWICK LOOP, FAIRHOPE, AL 36532
(334) 300-2511
(334) 265-0945
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00014167
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000088588
—
AL
01
—
88588
BLUE CROSS BLUE SHIELD
AL
Enumeration date
08/19/2006
Last updated
11/24/2014
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