Healthcare Provider Details

I. General information

NPI: 1861629529
Provider Name (Legal Business Name): JAMES CURTIS VAUGHN PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2009
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 OAK ST ATTN: CREDENTIALS
CINCINNATI OH
45219-2504
US

IV. Provider business mailing address

9710 WIND DANCER
SAN ANTONIO TX
78251-4813
US

V. Phone/Fax

Practice location:
  • Phone: 513-984-1800
  • Fax: 513-984-4909
Mailing address:
  • Phone: 210-692-7400
  • Fax: 210-692-0900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: