Healthcare Provider Details

I. General information

NPI: 1639235633
Provider Name (Legal Business Name): HARRY C MCDONALD, M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 12/29/2023
Certification Date: 12/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 FALLS RD
TOCCOA GA
30577-6228
US

IV. Provider business mailing address

201 FALLS RD
TOCCOA GA
30577-6228
US

V. Phone/Fax

Practice location:
  • Phone: 706-886-8476
  • Fax: 706-282-0134
Mailing address:
  • Phone: 706-886-8476
  • Fax: 706-282-0134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number027223
License Number StateGA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JENNIFER E HALSEY
Title or Position: MANAGEMENT CONSULTANT
Credential: CCS-P
Phone: 706-886-8477