Provider Demographics
NPI:1144423005
Name:VAUGHN, ALISHA STOCKTON (MD)
Entity Type:Individual
Prefix:DR
First Name:ALISHA
Middle Name:STOCKTON
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALISHA
Other - Middle Name:DENETTE
Other - Last Name:STOCKTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:358 BRIAR VIEW DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39042-8228
Mailing Address - Country:US
Mailing Address - Phone:601-519-9579
Mailing Address - Fax:
Practice Address - Street 1:151 E METRO DR
Practice Address - Street 2:SUITE 102
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-4402
Practice Address - Country:US
Practice Address - Phone:601-992-2292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS20656208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics