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NPI Code Detail

MEDICARE: DR. JENTRY MCLAUGHLIN D.O.

MEDICARE: DR. JENTRY MCLAUGHLIN D.O.
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
1207P00000XEmergency Medicine Physician6444OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780110221
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENTRY MCLAUGHLIN D.O.
Provider Business Mailing Address
First Line : 1200 E PECAN ST
Second Line :
City : ALTUS
State : OK
Zip : 73521-6141
Country : US
Telephone Number : 580-379-5000
Fax Number : 580-379-5509
Provider Business Practice Location Address
First Line : 1200 E PECAN ST
Second Line :
City : ALTUS
State : OK
Zip : 73521-6192
Country : US
Telephone Number : 580-379-5000
Fax Number : 580-379-5509
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2017
Last Update Date : 11/21/2023

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