Healthcare Provider Details

I. General information

NPI: 1730224015
Provider Name (Legal Business Name): WILLIAM ALOYISUS MCLAUGHLIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 01/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

463142 STATE ROAD 200
YULEE FL
32097-5554
US

IV. Provider business mailing address

382 S FLETCHER AVE
FERNANDINA BEACH FL
32034-4809
US

V. Phone/Fax

Practice location:
  • Phone: 904-225-8280
  • Fax:
Mailing address:
  • Phone: 904-321-0961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberME96651
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: