Provider Demographics
NPI:1427162023
Name:MCLAUGHLIN, GEORGE EARL (PA-C)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:EARL
Last Name:MCLAUGHLIN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 FARR RD STE 5000
Mailing Address - Street 2:
Mailing Address - City:NORTON SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:49444-7789
Mailing Address - Country:US
Mailing Address - Phone:231-739-9095
Mailing Address - Fax:231-739-6439
Practice Address - Street 1:1450 FARR RD STE 5000
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49444-7789
Practice Address - Country:US
Practice Address - Phone:231-739-9095
Practice Address - Fax:231-739-6439
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601002485363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI6945004Medicare PIN