Individual
CHRISTOPHER TROTTER VAUGHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
301 W MYRTLE ST, BOISE, ID 83702-7656
(208) 342-8200
(208) 342-8202
Mailing address
301 W MYRTLE ST, BOISE, ID 83702-7656
(208) 342-8200
(208) 342-8202
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
BP10053072
OR
207L00000X
Anesthesiology Physician
M15294
ID
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
M15294
ID
Other
Enumeration date
06/08/2015
Last updated
10/28/2022
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