Individual
PAUL T VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
119 MAPLEWOOD AVE, RONCEVERTE, WV 24970-9737
(304) 647-5642
(304) 647-5644
Mailing address
119 MAPLEWOOD AVE, RONCEVERTE, WV 24970-9737
(304) 647-5642
(304) 647-5644
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
01034
WV
Other
Enumeration date
09/23/2005
Last updated
04/21/2022
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