Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 7960 | KY |
N | 204E00000X | Oral & Maxillofacial Surgeon | 7960 | KY |
NPI | 1265518187 |
---|---|
Provider Name | Donald R Mclaurin |
First Address | Mt Sterling, KY 40353-1267 |
Second Address | Mt Sterling, KY 40353-1267 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2006 |
Last Update Date | 15/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64942584 | (05) | KY |
G19409 | (02) | KY |