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Individual

DR. JEFFREY VAUGHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2033 MEADOWVIEW LN, 3RD FLOOR, KINGSPORT, TN 37660-7569
(423) 857-2793
(423) 578-8025
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(423) 857-2066
(423) 857-2070

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101041214
VA
207Q00000X
Family Medicine Physician
Primary
18226
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005613612
VA
05
3033474
TN
05
3345605
TN
05
5613612
VA
Enumeration date
06/01/2005
Last updated
05/15/2014
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