Provider Demographics
NPI:1962797712
Name:MCLAUGHLIN, MERRITT ECHOLS (MD)
Entity type:Individual
Prefix:
First Name:MERRITT
Middle Name:ECHOLS
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 FLUKER STREET FAMILY MEDICINE
Mailing Address - Street 2:
Mailing Address - City:THOMSON
Mailing Address - State:GA
Mailing Address - Zip Code:30824-7024
Mailing Address - Country:US
Mailing Address - Phone:706-595-1090
Mailing Address - Fax:
Practice Address - Street 1:315 FLUKER STREET FAMILY MEDICINE
Practice Address - Street 2:
Practice Address - City:THOMSON
Practice Address - State:GA
Practice Address - Zip Code:30824-7024
Practice Address - Country:US
Practice Address - Phone:706-595-1090
Practice Address - Fax:706-595-6010
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0078453207Q00000X
SCLL33533207R00000X
GA80472207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003221449AMedicaid
MD382962YVZMedicare PIN
MD382961YWV2Medicare PIN