Healthcare Provider Details

I. General information

NPI: 1407827868
Provider Name (Legal Business Name): KAY L MCLAUGHLIN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 S OAKLAND ST SUITE 204
SAINT JOHNS MI
48879-2200
US

IV. Provider business mailing address

901 S OAKLAND ST SUITE 204
SAINT JOHNS MI
48879-2200
US

V. Phone/Fax

Practice location:
  • Phone: 989-224-2338
  • Fax: 989-224-2065
Mailing address:
  • Phone: 989-224-2338
  • Fax: 989-224-2065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberKM011051
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: