Provider Demographics
NPI:1538154851
Name:VAUGHAN, JOHN J (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:VAUGHAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1760 NICHOLASVILLE RD
Mailing Address - Street 2:SUITE 604
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1471
Mailing Address - Country:US
Mailing Address - Phone:859-255-9059
Mailing Address - Fax:859-254-3112
Practice Address - Street 1:1760 NICHOLASVILLE RD
Practice Address - Street 2:SUITE 604
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1471
Practice Address - Country:US
Practice Address - Phone:859-255-9059
Practice Address - Fax:859-254-3112
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2010-07-19
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Provider Licenses
StateLicense IDTaxonomies
KY25279207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY666073OtherANTHEM BCBS
KY000000050370OtherANTHEM BCBS
KY64252794Medicaid
KY666073OtherANTHEM BCBS
C76521Medicare UPIN
KY64252794Medicaid