Individual
DR. RANDALL L VAUGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
501 S PRESTON ST, LOUISVILLE, KY 40292-0001
(502) 852-5128
(502) 852-7163
Mailing address
501 S PRESTON ST, LOUISVILLE, KY 40292-0001
(502) 852-5128
(502) 852-7163
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6779
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004488
DORAL DENTAL
—
05
—
60067790
—
KY
Enumeration date
10/26/2006
Last updated
07/08/2007
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