Individual
CAROLYN ROENA VAUGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
109 PHYSICIANS DR STE A, GREER, SC 29650-2446
(864) 797-9150
(864) 797-9155
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
210102
NC
207Q00000X
Family Medicine Physician
Primary
87020
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
SC
Enumeration date
05/12/2015
Last updated
03/22/2022
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