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Organization
MCDONOUGH PRIMARY CARE INC
Active
Organization
MCDONOUGH PRIMARY CARE INC
Active
Other names
Keys Ferry Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM HARRELL VAN LAAR DO (OWNER)
(770) 914-0342
Entity
Organization
Contact information
Practice address
68 HAMPTON ST, MCDONOUGH, GA 30253-3150
(770) 914-0342
(770) 914-0493
Mailing address
68 HAMPTON ST, MCDONOUGH, GA 30253-3150
(770) 914-0342
(770) 914-0493
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/10/2006
Last updated
11/09/2007
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