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Individual

MR. ROBERT VAUGHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
800 N FANT ST, ANDERSON, SC 29621-5708
(864) 512-1000
Mailing address
116 WINDAMERE RD, EASLEY, SC 29640-1338
(864) 306-9535
(864) 306-9535

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AA706
MEDICARE
SC
Enumeration date
10/13/2006
Last updated
03/29/2019
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