Healthcare Provider Details

I. General information

NPI: 1053574376
Provider Name (Legal Business Name): MICHAEL DAVID MCLAUGHLIN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2008
Last Update Date: 03/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6655 S. YALE AVE. LAUREATE PSYCHIATRIC CLINIC & HOSPITAL
TULSA OK
74136-3326
US

IV. Provider business mailing address

6600 S YALE AVE STE 1200
TULSA OK
74136-3361
US

V. Phone/Fax

Practice location:
  • Phone: 918-491-5752
  • Fax: 918-491-5753
Mailing address:
  • Phone: 918-491-5752
  • Fax: 491-491-5753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number4664
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number4664
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: