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Individual

JACOB VAUGHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2400 CORNWELL DR, YUKON, OK 73099-5804
(405) 354-7449
(405) 354-0833
Mailing address
2400 CORNWELL DR, YUKON, OK 73099-5804
(405) 354-7449

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
20464
OK

Other

Enumeration date
04/22/2024
Last updated
04/22/2024
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