Individual
DR. JACOB WALKER VAUGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2750 DANTZLER DR UNIT 102, NORTH CHARLESTON, SC 29406-9006
(843) 876-1818
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-1414
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
94543
SC
208M00000X
Hospitalist Physician
94543
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2021
Last updated
11/17/2025
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