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NPI Code Detail

MEDICARE: FREDERICK MCLAUGHLIN SR.

MEDICARE: FREDERICK MCLAUGHLIN SR.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker

General Provider Information

NPI Number : 1457890048
Entity Type Code : Individual
Provider Name (Legal Business Name) : FREDERICK MCLAUGHLIN SR.
Provider Business Mailing Address
First Line : 410 E CHURCH ST
Second Line :
City : FORT VALLEY
State : GA
Zip : 31030-3097
Country : US
Telephone Number : 478-662-1421
Fax Number :
Provider Business Practice Location Address
First Line : 410 E CHURCH ST
Second Line :
City : FORT VALLEY
State : GA
Zip : 31030-3097
Country : US
Telephone Number : 478-662-1421
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2017
Last Update Date : 02/16/2017

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