Provider Demographics
NPI:1104870971
Name:MCLAUGHLIN, WILLIAM DAVIS (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DAVIS
Last Name:MCLAUGHLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 HONEYSUCKLE RD
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36305
Mailing Address - Country:US
Mailing Address - Phone:334-836-1212
Mailing Address - Fax:334-836-1888
Practice Address - Street 1:480 HONEYSUCKLE RD
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305
Practice Address - Country:US
Practice Address - Phone:334-836-1212
Practice Address - Fax:334-836-1888
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12752207RG0100X
GA077288207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1199647OtherUNITED HEALTHCARE
AL051001790OtherBLUE CROSS BLUE SHIELD
AL051556206Medicaid
GA00342427AMedicaid
AL051518355OtherBLUE CROSS BLUE SHIELD AL
P00231091OtherRAILROAD MEDICARE
AL051518355OtherBLUE CROSS BLUE SHIELD AL
1199647OtherUNITED HEALTHCARE
P00231091OtherRAILROAD MEDICARE
ALK486Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER