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Individual

DR. KORY GREGGS VAUGHN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
640 N BROAD ST, APT 101, PHILADELPHIA, PA 19130-3420
(678) 596-4621
Mailing address
640 N BROAD ST, APT 101, PHILADELPHIA, PA 19130-3420

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MT197942
PA

Other

Enumeration date
09/07/2012
Last updated
02/04/2013
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