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NPI Code Detail

MEDICARE: MR. JERRY T MCLAUGHLIN PA

MEDICARE:  MR. JERRY T MCLAUGHLIN  PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant750OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952373326
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JERRY T MCLAUGHLIN PA
Provider Business Mailing Address
First Line : 3110 SW 89TH ST STE 200E
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73159-7919
Country : US
Telephone Number : 405-733-7300
Fax Number : 405-733-7333
Provider Business Practice Location Address
First Line : 3110 SW 89TH ST
Second Line : SUITE 200E
City : OKLAHOMA CITY
State : OK
Zip : 73159-7920
Country : US
Telephone Number : 405-733-7300
Fax Number : 405-733-7333
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2006
Last Update Date : 08/01/2013

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Directions to “ MR. JERRY T MCLAUGHLIN PA” Practice Location

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