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Individual

DR. LARRY D VAUGHT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
5512 S LEWIS AVE, TULSA, OK 74105-7140
(918) 747-1600
(918) 749-2774
Mailing address
5512 S LEWIS AVE, TULSA, OK 74105-7140
(918) 747-1600
(918) 749-2774

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
441
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100838930A
OK
01
730703797008
BCBS
OK
01
731351277
HUMANA
OK
Enumeration date
11/16/2006
Last updated
07/08/2007
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