Provider Demographics
NPI:1255431656
Name:MCLAUGHLIN, THOMAS (PA)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:MCLAUGHLIN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15821 POPLAR TENT RD
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-4615
Mailing Address - Country:US
Mailing Address - Phone:704-987-8142
Mailing Address - Fax:
Practice Address - Street 1:1401 E 7TH ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2407
Practice Address - Country:US
Practice Address - Phone:704-333-5606
Practice Address - Fax:704-333-5611
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC100284363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP09257Medicare UPIN
NC2752712BMedicare ID - Type Unspecified