Individual
DR. JOHN WATT VAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7810 PROVIDENCE RD, SUITE 102, CHARLOTTE, NC 28226-2954
(704) 543-6636
(704) 752-4185
Mailing address
7810 PROVIDENCE RD, SUITE 102, CHARLOTTE, NC 28226-2954
(704) 543-6636
(704) 752-4185
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00-33439
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84873
BLUE CROSS BLUE SHIELD
NC
05
—
8984873
—
NC
Enumeration date
08/05/2006
Last updated
02/19/2010
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