Provider Demographics
NPI:1003941519
Name:MCLAUGHLIN, SHANNON G (M D)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:G
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14300 CHENAL PKWY
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-5805
Mailing Address - Country:US
Mailing Address - Phone:501-202-1664
Mailing Address - Fax:501-202-1611
Practice Address - Street 1:14300 CHENAL PKWY
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-5805
Practice Address - Country:US
Practice Address - Phone:501-202-1664
Practice Address - Fax:501-202-1611
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC7755207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5K814Medicare ID - Type Unspecified
ARF44510Medicare UPIN