Provider Demographics
NPI:1679564181
Name:LAUGHLIN, ROGER D (RPH)
Entity type:Individual
Prefix:MR
First Name:ROGER
Middle Name:D
Last Name:LAUGHLIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5827 OVERBROOKE RD
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45440-2334
Mailing Address - Country:US
Mailing Address - Phone:937-435-4397
Mailing Address - Fax:
Practice Address - Street 1:4865 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-1932
Practice Address - Country:US
Practice Address - Phone:513-858-4700
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03309189183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist