Provider Demographics
NPI:1225071640
Name:LAUGHLIN, MARY C (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:C
Last Name:LAUGHLIN
Suffix:
Gender:F
Credentials:MD
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 2027
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52244-2027
Mailing Address - Country:US
Mailing Address - Phone:319-339-3855
Mailing Address - Fax:319-339-3935
Practice Address - Street 1:503 3RD ST
Practice Address - Street 2:
Practice Address - City:KALONA
Practice Address - State:IA
Practice Address - Zip Code:52247-9526
Practice Address - Country:US
Practice Address - Phone:319-656-3151
Practice Address - Fax:319-656-3319
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA33187207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA080181751OtherRAILROAD MEDICARE
IA0216200Medicaid
C18185Medicare UPIN
IA0216200Medicaid