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Individual

DR. VAUGHN DANIEL BLACKBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
5 W MAIN ST, AMELIA, OH 45102-1924
(513) 753-0500
(513) 986-0218
Mailing address
6200 PLEASANT AVE, SUITE 3, FAIRFIELD, OH 45014-4670
(513) 829-9333
(513) 858-7827

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36003708
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0119172
OH
05
201371230
IN
05
7100441710
KY
Enumeration date
09/07/2011
Last updated
02/12/2020
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