Provider Demographics
NPI:1346245511
Name:MCLAUGHLIN, MARION D (MD)
Entity type:Individual
Prefix:
First Name:MARION
Middle Name:D
Last Name:MCLAUGHLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:303 MED TECH PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-2391
Mailing Address - Country:US
Mailing Address - Phone:423-282-5611
Mailing Address - Fax:423-282-5712
Practice Address - Street 1:303 MED TECH PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-2391
Practice Address - Country:US
Practice Address - Phone:423-282-5611
Practice Address - Fax:423-282-5712
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN24272207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
10838099OtherCAQH
TN3074969Medicaid
TNBM3551252OtherDEA
TN3074969Medicaid
TN3074968Medicare PIN