Provider Demographics
NPI:1316959091
Name:LAUGHLIN, EDWARD J (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:J
Last Name:LAUGHLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5501 NW 62ND TER
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64151-2408
Mailing Address - Country:US
Mailing Address - Phone:913-584-8884
Mailing Address - Fax:913-945-9612
Practice Address - Street 1:10787 NALL AVE.
Practice Address - Street 2:SUITE 300
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1372
Practice Address - Country:US
Practice Address - Phone:913-588-9400
Practice Address - Fax:913-588-9450
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2015-09-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR6F84207RC0000X
KS04-26656207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100328390AMedicaid
MO12427043OtherBCBS KC
KS100328390BMedicaid
KS051554OtherBCBS KS
MO208516310Medicaid
C51844Medicare UPIN
MO0385719AMedicare PIN
MO208516310Medicaid
KS100328390AMedicaid
MO12427043OtherBCBS KC
MO0385719EMedicare PIN
KS0385719BMedicare PIN
KS060062384Medicare PIN