Basic Information
Provider Information
NPI: 1649774068
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LAUGHLIN
FirstName: DEVON
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
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OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1600 ROCKLAND RD
Address2:  
City: WILMINGTON
State: DE
PostalCode: 198033607
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1047 OLD YORK RD
Address2:  
City: ABINGTON
State: PA
PostalCode: 190014627
CountryCode: US
TelephoneNumber: 2158861240
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/20/2018
LastUpdateDate: 11/15/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/04/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XMT215267PAN Allopathic & Osteopathic PhysiciansPediatrics 
208000000XC7-0006837DEN Allopathic & Osteopathic PhysiciansPediatrics 
208000000XMD474960PAY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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