Organization
DRS. LONG AND VAUGHAN, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD REID VAUGHAN M.D. (CORPORATE PRESIDENT)
(864) 295-2444
Entity
Organization
Contact information
Practice address
18 MEMORIAL MEDICAL DR, GREENVILLE, SC 29605-4452
(864) 295-2444
Mailing address
18 MEMORIAL MEDICAL DR, GREENVILLE, SC 29605-4452
(864) 295-2444
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
10030
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA2924
—
SC
Enumeration date
05/11/2006
Last updated
08/22/2020
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