Individual
JAMES DYLAN VAUGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1406 MAIN ST, CONWAY, SC 29526-3567
(843) 488-4147
(843) 488-0141
Mailing address
1406 MAIN ST, CONWAY, SC 29526-3567
(843) 488-4147
(843) 488-0141
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1724
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D17248
—
SC
Enumeration date
08/08/2012
Last updated
12/01/2023
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