Individual
MR. MICHAEL LEE VAUGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPH
Contact information
Practice address
540 PLAZA CT, SAND SPRINGS, OK 74063-7915
(918) 245-9693
(918) 245-5906
Mailing address
39701 W 21ST ST S, MANNFORD, OK 74044-2835
(918) 865-7848
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9852
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9852
PHARMACIST LICENSE
OK
Enumeration date
08/30/2006
Last updated
07/08/2007
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