Healthcare Provider Details

I. General information

NPI: 1962328336
Provider Name (Legal Business Name): MCLAURINE MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 KENTUCKY AVE FL 5
PADUCAH KY
42003-3813
US

IV. Provider business mailing address

PO BOX 5
MURRAY KY
42071-0001
US

V. Phone/Fax

Practice location:
  • Phone: 270-963-5564
  • Fax:
Mailing address:
  • Phone: 270-963-5564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: TYLER MCLAURINE
Title or Position: OWNER
Credential: MD
Phone: 270-963-5564