Basic Information
| Provider Information | |||||||||
| NPI: | 1003876707 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCLAULIN | ||||||||
| FirstName: | JOHN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 155 BROOKS AVE | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024746623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7816433965 | ||||||||
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| Practice Location | |||||||||
| Address1: | 25 HIGHLAND AVE | ||||||||
| Address2: | |||||||||
| City: | NEWBURYPORT | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019503867 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9784631050 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2006 | ||||||||
| LastUpdateDate: | 04/24/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 77536 | MA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | J30102 | 01 | MA | BLUE SHIELD | OTHER | 3112543 | 05 | MA | MEDICAID |