Individual
CONRAD SCOTT VAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
312 PROSPERITY RD, SUITE 101, KNOXVILLE, TN 37923-4721
(865) 691-3155
(865) 694-8093
Mailing address
4307 BALL CAMP PIKE, KNOXVILLE, TN 37921-3313
(865) 524-1234
(865) 524-2169
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC1753
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003156082
BLUE CROSS BLUE SHIELD
TN
Enumeration date
06/15/2006
Last updated
01/26/2012
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