Individual
VAUGHN D TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1834 CLAIRMONT RD # 100, DECATUR, GA 30033-3405
(404) 634-4443
(708) 848-5270
Mailing address
4085 CREEKVIEW RIDGE DR, BUFORD, GA 30518-8743
(773) 587-2616
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-056693
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036056693
—
IL
Enumeration date
08/30/2006
Last updated
09/18/2020
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