Provider Demographics
NPI:1992064091
Name:VAUGHAN, TAMMY J (AUD)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:J
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 MEDICAL CENTER DR STE 303
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-7915
Mailing Address - Country:US
Mailing Address - Phone:270-444-4222
Mailing Address - Fax:270-444-4223
Practice Address - Street 1:225 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-7914
Practice Address - Country:US
Practice Address - Phone:270-444-4222
Practice Address - Fax:270-444-4223
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0552231H00000X
KY100037231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist