Individual
WILLIAM M VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1000 HAWTHORNE AVE, SUITE O, ATHENS, GA 30606-2168
(706) 353-0093
(703) 353-0096
Mailing address
1000 HAWTHORNE AVE, SUITE O, ATHENS, GA 30606-2168
(706) 353-0093
(703) 353-0096
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004329
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
STATE LICENSE
004329
GA
Enumeration date
04/12/2007
Last updated
07/08/2007
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