Individual
MR. BRENNAN FOSTER VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1420 RAYMOND RD, JACKSON, MS 39204-4358
(601) 387-3400
Mailing address
1420 RAYMOND RD, JACKSON, MS 39204-4358
(601) 387-3400
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
PA00323
MS
363A00000X
Physician Assistant
PA00323
MS
Other
Enumeration date
02/15/2017
Last updated
04/20/2026
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