Individual
TONYA VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24800 CHAGRIN BLVD, SUITE 211, BEACHWOOD, OH 44122-5648
(216) 896-0316
(216) 896-9997
Mailing address
24800 CHAGRIN BLVD, SUITE 211, BEACHWOOD, OH 44122-5648
(216) 896-0316
(216) 896-9997
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
5656
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00002660
WELLCARE
OH
05
—
0188872
—
OH
01
—
341883505026
CARESOURCE
OH
01
—
62383
DAVIS VISION
OH
Enumeration date
03/15/2006
Last updated
09/20/2011
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