Basic Information
| Provider Information | |||||||||
| NPI: | 1508044066 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCLAUGHLIN | ||||||||
| FirstName: | RENEE | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 963 PONCE DE LEON AVE NE | ||||||||
| Address2: | APARTMENT 111 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303064254 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6166179068 | ||||||||
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| Practice Location | |||||||||
| Address1: | 550 PEACHTREE STREET | ||||||||
| Address2: | 6TH FLOOR, M.O.T. - CARDIOTHORACIC SURGERY | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303084255 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4046862513 | ||||||||
| FaxNumber: | 4046864959 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2008 | ||||||||
| LastUpdateDate: | 02/07/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | 1685 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.