Organization
DOERUN HEALTHCARE L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS ALEXANDER MAC KEAN FNP-C (PRESIDENT)
(229) 782-5048
Entity
Organization
Contact information
Practice address
217 WEST BROAD AVE, DOERUN, GA 31744-0459
(229) 782-5048
(229) 782-5049
Mailing address
217 WEST BROAD AVE, PO BOX 459, DOERUN, GA 31744-0459
(229) 782-5048
(229) 782-5049
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN146046
GA
Other
Enumeration date
09/11/2007
Last updated
09/11/2007
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