Basic Information
| Provider Information | |||||||||
| NPI: | 1588991863 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCLAUGHLIN | ||||||||
| FirstName: | COLEEN | ||||||||
| MiddleName: | MAY | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 132 FRANKLIN SPRINGS ST | ||||||||
| Address2: | |||||||||
| City: | ROYSTON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 306624134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7062457371 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 132 FRANKLIN SPRINGS ST | ||||||||
| Address2: | |||||||||
| City: | ROYSTON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 306624134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7062457371 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2009 | ||||||||
| LastUpdateDate: | 01/12/2010 | ||||||||
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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 | 363A00000X | 5720 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.