| Tiffany Vaughan, | |
|
1500 Wilson Loop, Ward, AR 72176 | |
| (501) 941-5630 | |
| Not Available |
| Full Name | Tiffany Vaughan |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist |
| Location | 1500 Wilson Loop, Ward, Arkansas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861528358 | NPI | - | NPPES |
| 5Y668 | Other | AR | BLUE CROSS BLUE SHEILD |
| 159501721 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | OTR2030 (Arkansas) | Primary |
| Provider Name | University Of Central Arkansas |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1912543240 PECOS PAC ID: 0042612244 Enrollment ID: O20210712000255 |
| Mailing Address | Practice Location Address |
|---|---|
| Tiffany Vaughan, 1500 Wilson Loop, Ward, AR 72176-8656 Ph: (501) 588-3211 | Tiffany Vaughan, 1500 Wilson Loop, Ward, AR 72176 Ph: (501) 941-5630 |
Glyn Elwin Sawyer, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1500 Wilson Loop, Ward, AR 72176 Phone: 501-941-5630 | |
Mr. Brad Thomas Westbrook, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1500 Wilson Loop, Ward, AR 72176 Phone: 501-941-5630 | |
Zachary Fendley, Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 1500 Wilson Loop, Ward, AR 72176 Phone: 501-941-5630 Fax: 501-353-2599 | |
Beyond Boundaries, Inc Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2195 Peyton Street, Ward, AR 72176 Phone: 501-941-5630 | |
Johanna Bevis, Occupational Therapist Medicare: Medicare Enrolled Practice Location: 1500 Wilson Loop, Ward, AR 72176 Phone: 501-941-1522 | |
Mr. William Brian Brady, MS OTRL Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1500 Wilson Loop, Ward, AR 72176 Phone: 501-941-5630 | |
Kari Bridges, MS, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1500 Wilson Loop, Ward, AR 72176 Phone: 501-941-5630 Fax: 501-843-2270 |