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Individual

TERRY VAUGHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
SURGE BLDG. 1-WEST, 2701 FRONTIER NE, ALBUQUERQUE, NM 87106
(505) 272-2610
Mailing address
2701 FRONTIER NE, MSC11 6120, ALBUQUERQUE, NM 87106
(505) 272-2610

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
R20523
NM

Other

Enumeration date
08/02/2006
Last updated
07/08/2007
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