Provider Demographics
NPI:1528057429
Name:MCLOUGHLIN, THOMAS M (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:M
Last Name:MCLOUGHLIN
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 1:1200 S CEDAR CREST BLVD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6202
Mailing Address - Country:US
Mailing Address - Phone:610-402-8000
Mailing Address - Fax:
Practice Address - Street 1:1200 S CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6202
Practice Address - Country:US
Practice Address - Phone:610-402-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD057251L207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA822005OtherBLUE CROSS OF NORTHEASTERN PA
0000000087460OtherUNISON - FORMERLY THREE RIVERS
PA0015645920004Medicaid
PA01513980OtherGATWAY
PA20013548OtherAMERIHEALTH MERCY
PA729742OtherHIGHMARK
PA01213202OtherCAPITAL ADVANTAGE
PA0572040000OtherINDEP. BLUE CROSS
PA20013548OtherKEYSTONE MERCY
PA01513980OtherGATWAY
PAG22818Medicare UPIN
PA729742OtherHIGHMARK