Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 0101237916 | VA |
N | 207V00000X | Obstetrician & Gynecologist | D0062938 | MD |
N | 207V00000X | Obstetrician & Gynecologist | MD035459 | DC |
N | 207V00000X | Obstetrician & Gynecologist | ME97643 | FL |
Y | 207VG0400X | Gynecologist | ME97643 | FL |
NPI | 1033164231 |
---|---|
Provider Name | Dr. Jessica M. Vaught |
First Address | Orlando, FL 32806-1133 |
Second Address | Orlando, FL 32806-1133 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 11/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
277453400 | (05) | FL |
ME97643 | MEDICAL LICENSE (01) | FL |