Provider Demographics
NPI:1427349588
Name:VAUGHAN, JENNIFER E (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:E
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:222 PIEDMONT AVE
Mailing Address - Street 2:SUITE 3200
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-4231
Mailing Address - Country:US
Mailing Address - Phone:513-475-8730
Mailing Address - Fax:513-475-7839
Practice Address - Street 1:222 PIEDMONT AVE
Practice Address - Street 2:SUITE 3200
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-4231
Practice Address - Country:US
Practice Address - Phone:513-475-8730
Practice Address - Fax:513-475-7839
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-25
Last Update Date:2017-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH351316902084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program