Brennan F Vaughn (NPI# 1689113250, PAC ID# 8628354131) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1689113250 |
| PAC ID by PECOS | 8628354131 |
| Professional Enrollment ID | I20170418002129 |
| Full Name | Brennan F Vaughn |
| Organization Legal Name | MEA PRIMARY CARE PLUS, LLC |
| Address |
4204 Clay St Vicksburg MS 39183-3438 |
| Phone Number | 6016197717 |
| Gender | M |
| Graduation Year | 2017 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 0941583728 |
| Number of Group Practice Members | 48 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 250048 | ST DOMINIC-JACKSON MEMORIAL HOSPITAL |
| 250031 | MERIT HEALTH RIVER REGION |
| Address | Phone | Organization |
|---|---|---|
| 342 Gilchrist Dr, Pearl, MS 39208-6671 | 6019390700 | MEA PRIMARY CARE PLUS, LLC |
| 4204 Clay St, Vicksburg, MS 39183-3438 | 6016197717 | MEA PRIMARY CARE PLUS, LLC |
| Organization Legal Name | MEA PRIMARY CARE PLUS, LLC |
| Physicians | 50 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Moumita Do Biswas | Family Medicine | Mea Primary Care Plus, LLC | 106 Lake Vista Pl, Brandon, MS 39047-6384 |
| Heather Haynes Walker | Nurse Practitioner | Mea Primary Care Plus, LLC | 323 Hwy 51, Ridgeland, MS 39157-3428 |
| Bethany Sumerford | Nurse Practitioner | Mea Primary Care Plus, LLC | 498 Hwy 80 E, Mea Primary Care Plu, Clinton, MS 39056-4720 |
| Tyler Ladner | Physician Assistant | Mea Primary Care Plus, LLC | 112 Southlake Cir, Canton, MS 39046-5368 |
| Michael L Brasel | Physician Assistant | Mea Primary Care Plus, LLC | 935 Hwy 51, Madison, MS 39110-8407 |
| Patrise Bennett | Family Medicine | Mea Primary Care Plus, LLC | 1777 Ellis Ave, Jackson, MS 39204-3616 |
| Diana Lynn Entrekin | Family Medicine | Mea Primary Care Plus, LLC | 5606 Old Canton Rd, Jackson, MS 39211-4217 |
| John Brooks | Emergency Medicine | Mea Primary Care Plus, LLC | 342 Gilchrist Dr, Pearl, MS 39208-6671 |
| Robert L Russell | Family Medicine | Mea Primary Care Plus, LLC | 1515 Jefferson St, Laurel, MS 39440-4244 |
| Carole Lynne Singleton | Nurse Practitioner | Mea Primary Care Plus, LLC | 307 E Fifteenth St, Yazoo City, MS 39194-2631 |
| Street Address |
4204 CLAY ST |
| City | VICKSBURG |
| State | MS |
| Zip | 39183-3438 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mandeep K Bajwa | Family Practice | First Intermed Corporation | 4204 Clay St, Vicksburg, MS 39183-3438 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tabitha Nicole Allen | Nurse Practitioner | Wound Care Associates LLC | 2100 Hwy 61 N, Promise Hosp, Vicksburg, MS 39183 |
| Natasha Yvonneavion West | Nurse Practitioner | Wound Care Associates LLC | 2100 Hwy 61 N, Promise Hosp, Vicksburg, MS 39183 |
| Kelly W Ryder | Internal Medicine | Vicksburg Healthcare LLC | 2100 Hwy 61 N, Vicksburg, MS 39183 |
| Annette Bryant | Clinical Social Worker | 1107 B Openwood St, Vicksburg, MS 39183-2533 | |
| Michelle D Banks | Nurse Practitioner | 919 Mission, Suite 66, Vicksburg, MS 39183-2751 | |
| Mary C Strong | Nurse Practitioner | Vicksburg Holistic Healthcare LLC | 919 Mission, Suite 66, Vicksburg, MS 39183-2751 |
| Carrie Willis Eure | Physician Assistant | Vicksburg Clinic LLC | 104 Mcauley Dr, Vicksburg, MS 39183-2825 |
| Joyce Wanjugu Muruthi | Obstetrics/gynecology | Vicksburg Clinic LLC | 104 Mcauley Dr, Vicksburg, MS 39183-2825 |
| Kent Ian Kossoy | General Surgery | Vicksburg Clinic LLC | 104 Mcauley Dr, Vicksburg, MS 39183-2825 |
| Feras M Hamadeh | Internal Medicine | Vicksburg Clinic LLC | 104 Mcauley Dr, Vicksburg, MS 39183-2825 |
| Find all physicians in zip 39183 | |||
| City | VICKSBURG |
| Zip Code | 39183 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | VICKSBURG + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Brennan F Vaughn.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.