Individual
DR. CORY B MAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
169 N GATEWAY DR STE 100, PROVIDENCE, UT 84332
(541) 999-4475
Mailing address
7300 RANCH ROAD 2222, BLDG 1, STE 200, AUSTIN, TX 78730-3255
(512) 759-8932
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
DO155462
OR
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
9869105-1204
UT
208D00000X
General Practice Physician
PG151474
OR
Other
Enumeration date
06/22/2010
Last updated
02/16/2023
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