Provider Demographics
NPI:1053948406
Name:GAUGHAN, THOMAS
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:GAUGHAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 ROSE ST RM C-368
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0293
Mailing Address - Country:US
Mailing Address - Phone:859-218-1661
Mailing Address - Fax:859-257-7167
Practice Address - Street 1:800 ROSE ST RM C-368
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0293
Practice Address - Country:US
Practice Address - Phone:859-218-1661
Practice Address - Fax:859-257-7167
Is Sole Proprietor?:No
Enumeration Date:2020-03-25
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program