| K Loor Medical Llc | |
|
1750 Marietta Hwy Ste 250 Canton GA 30114-8388 | |
| (678) 880-9990 | |
| (678) 880-8834 |
| Full Name | K Loor Medical Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1750 Marietta Hwy Ste 250, Canton, Georgia |
| Authorized Official Name and Position | Jeffrey Allan Donohue (MEDICAL DIRECTOR) |
| Authorized Official Contact | 6788809990 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| K Loor Medical Llc 1750 Marietta Hwy Ste 250 Canton GA 30114-8388 Ph: (678) 880-9990 | K Loor Medical Llc 1750 Marietta Hwy Ste 250 Canton GA 30114-8388 Ph: (678) 880-9990 |
| NPI Number | 1417571142 |
|---|---|
| Provider Enumeration Date | 05/28/2020 |
| Last Update Date | 05/28/2020 |
| Medicare PECOS PAC ID | 1951717529 |
|---|---|
| Medicare Enrollment ID | O20210304002916 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417571142 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jeffrey A Donohue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639100480 PECOS PAC ID: 7618980053 Enrollment ID: I20110317000457 |
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