Healthcare Provider Details

I. General information

NPI: 1568486173
Provider Name (Legal Business Name): MATTHEW M LAUGHON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MANNING DR
CHAPEL HILL NC
27599-0001
US

IV. Provider business mailing address

143 W FRANKLIN ST
CHAPEL HILL NC
27516-2539
US

V. Phone/Fax

Practice location:
  • Phone: 919-966-8596
  • Fax: 919-843-5515
Mailing address:
  • Phone: 919-966-8596
  • Fax: 919-843-5515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number9901566
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier89136W4,
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: