Healthcare Provider Details

I. General information

NPI: 1497789713
Provider Name (Legal Business Name): DONNA B. MCLAUGHLIN OD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 07/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 S WASHINGTON ST
WILKES BARRE PA
18701-3029
US

IV. Provider business mailing address

82 S WASHINGTON ST
WILKES BARRE PA
18701-3029
US

V. Phone/Fax

Practice location:
  • Phone: 570-823-0290
  • Fax: 570-823-8511
Mailing address:
  • Phone: 570-823-0290
  • Fax: 570-823-8511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. DONNA B MC LAUGHLIN
Title or Position: PROPRIETOR
Credential: O.D.
Phone: 570-823-0290