Provider Demographics
NPI:1093786063
Name:MC LAUGHLIN, THOMAS P (OD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:P
Last Name:MC LAUGHLIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 SHADY TREE DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN TOP
Mailing Address - State:PA
Mailing Address - Zip Code:18707-1555
Mailing Address - Country:US
Mailing Address - Phone:570-474-2112
Mailing Address - Fax:
Practice Address - Street 1:68 SHADY TREE DR
Practice Address - Street 2:
Practice Address - City:MOUNTAIN TOP
Practice Address - State:PA
Practice Address - Zip Code:18707-1555
Practice Address - Country:US
Practice Address - Phone:570-474-2112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2017-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000425152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA014873Medicare ID - Type Unspecified
PAU71712Medicare UPIN