Doerun Healthcare L.L.C.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN146046 Issued in GA

Legal business name

DOERUN HEALTHCARE L.L.C.

Practice address

217 West Broad Ave
Doerun, GA 31744-0459

Phone

(229) 782-5048

Fax

(229) 782-5049

NPI assigned

Sep 11, 2007

Last updated

Sep 11, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Thomas Alexander Mac Kean, FNP-C

Title

President

Phone

(229) 782-5048

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189468800000",
    "number": "1780879957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 WEST BROAD AVE",
            "address_2": "PO BOX 459",
            "city": "DOERUN",
            "state": "GA",
            "postal_code": "317440459",
            "telephone_number": "229-782-5048",
            "fax_number": "229-782-5049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 WEST BROAD AVE",
            "city": "DOERUN",
            "state": "GA",
            "postal_code": "317440459",
            "telephone_number": "229-782-5048",
            "fax_number": "229-782-5049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOERUN HEALTHCARE L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2007-09-11",
        "status": "A",
        "authorized_official_last_name": "MAC KEAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "229-782-5048",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN146046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Doerun, GA
• Providers in Doerun, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.