Provider Demographics
NPI:1699177477
Name:VAUGHN, DENTY PAUL JR (DVM)
Entity Type:Individual
Prefix:DR
First Name:DENTY
Middle Name:PAUL
Last Name:VAUGHN
Suffix:JR
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6100
Mailing Address - Street 2:240 WISE CENTER DR
Mailing Address - City:MISSISSIPPI STATE
Mailing Address - State:MS
Mailing Address - Zip Code:39762
Mailing Address - Country:US
Mailing Address - Phone:662-325-3432
Mailing Address - Fax:
Practice Address - Street 1:240 WISE CENTER DR
Practice Address - Street 2:
Practice Address - City:MISSISSIPPI STATE
Practice Address - State:MS
Practice Address - Zip Code:39762
Practice Address - Country:US
Practice Address - Phone:662-325-3432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2052174M00000X
AL6328174M00000X
FL12111174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian