Organization
VAUGHN BLACKBURN DPM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VAUGHN DANIEL BLACKBURN (DPM)
(513) 753-0500
Entity
Organization
Contact information
Practice address
5 W MAIN ST, AMELIA, OH 45102-1924
(513) 753-0500
(513) 986-0218
Mailing address
6200 PLEASANT AVE, STE 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
—
0139688
—
OH
05
—
201368390A
—
IN
05
—
7100441860
—
KY
Enumeration date
06/23/2015
Last updated
02/12/2020
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