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Individual

DR. DENNIS RYAN VAUGHN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1640 NORTH STATE HIGHWAY 121, MT. ZION, IL 62549
(217) 864-1922
(217) 864-1953
Mailing address
1640 NORTH STATE HIGHWAY 121, MT. ZION, IL 62549
(217) 864-1922
(217) 864-1953

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016005005
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
016005005
IL
Enumeration date
07/11/2006
Last updated
11/09/2016
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