Scg Lake Country LLC

Practice location

Address

401 C E Colston Dr, Marietta, OK 73448-1230

Phone

(580) 276-3318

Fax

(580) 276-2100

Mailing address

1240 Marbella Plaza Dr., Tampa, FL 33619-7905

Authorised official

Name

Robert Daniel Vaughan

Title

President

Phone

(813) 341-2700

Registered specialties

Registry record

NPI

1033110457

Entity type

Organization

NPI issued

9 Aug 2005

Record last updated

22 Jan 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.