Provider Demographics
NPI:1487694360
Name:MCLAURIN, ROBERT L JR (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:L
Last Name:MCLAURIN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6600 GREYWALLS LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-8204
Mailing Address - Country:US
Mailing Address - Phone:919-497-0113
Mailing Address - Fax:919-497-0115
Practice Address - Street 1:113 JOLLY ST
Practice Address - Street 2:
Practice Address - City:LOUISBURG
Practice Address - State:NC
Practice Address - Zip Code:27549-2239
Practice Address - Country:US
Practice Address - Phone:919-497-0113
Practice Address - Fax:919-497-0115
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC335492085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1412GOtherBCBS
NC8957368Medicaid
NC2182136DMedicare PIN
NC1412GOtherBCBS
NC8957368Medicaid