Provider Demographics
NPI:1437413069
Name:LAUGHLIN, MARY JANELLE (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:JANELLE
Last Name:LAUGHLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:13129 BLUEJACKET ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-4632
Mailing Address - Country:US
Mailing Address - Phone:913-897-7458
Mailing Address - Fax:913-897-7458
Practice Address - Street 1:13129 BLUEJACKET ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-4632
Practice Address - Country:US
Practice Address - Phone:913-897-7458
Practice Address - Fax:913-897-7458
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-23570207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology