Provider Demographics
NPI:1366615908
Name:MARTIN P. O'LAUGHLIN MD PC
Entity type:Organization
Organization Name:MARTIN P. O'LAUGHLIN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:P
Authorized Official - Last Name:O'LAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-381-5200
Mailing Address - Street 1:4400 BROADWAY ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3498
Mailing Address - Country:US
Mailing Address - Phone:816-931-5440
Mailing Address - Fax:816-931-6667
Practice Address - Street 1:4400 BROADWAY ST
Practice Address - Street 2:SUITE 400
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3498
Practice Address - Country:US
Practice Address - Phone:816-931-5440
Practice Address - Fax:816-931-6667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-03
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20020072872080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MON080000Medicare PIN