Provider Demographics
NPI:1801066493
Name:MCVAUGH, JAMES PEARSON (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PEARSON
Last Name:MCVAUGH
Suffix:
Gender:M
Credentials:DMD
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 661
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MS
Mailing Address - Zip Code:39730-0661
Mailing Address - Country:US
Mailing Address - Phone:662-369-6722
Mailing Address - Fax:662-369-1700
Practice Address - Street 1:138 N MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MS
Practice Address - Zip Code:39730-2636
Practice Address - Country:US
Practice Address - Phone:662-369-6722
Practice Address - Fax:662-369-1700
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1936-811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice