Provider Demographics
NPI:1174815609
Name:VAUGHAN, CATHERINE ALEXANDER (MD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ALEXANDER
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7691 POPLAR AVE # 3213
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3904
Mailing Address - Country:US
Mailing Address - Phone:901-516-6433
Mailing Address - Fax:901-516-6632
Practice Address - Street 1:7691 POPLAR AVE # 3213
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3904
Practice Address - Country:US
Practice Address - Phone:901-516-6433
Practice Address - Fax:901-516-6632
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY46760208000000X
MS249482080N0001X
390200000X
TN556002080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program