Individual
TOM BROOKS VAUGHAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2204 LAKESHORE DR, SUITE 410, BIRMINGHAM, AL 35209-6729
(205) 870-5678
(205) 879-0071
Mailing address
2204 LAKESHORE DR, SUITE 410, BIRMINGHAM, AL 35209-6729
(205) 870-5678
(205) 879-0071
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
MD.6420
AL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
6420
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000024822
—
AL
05
—
000082996
—
AL
01
—
1518026319
TRICARE SOUTH
AL
01
—
510-24822
BCBS
AL
01
—
510-82996
BCBS
AL
01
—
515-02331
FEDERAL BC
AL
Enumeration date
12/07/2006
Last updated
05/09/2013
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