Organization
MC MEDICAL LLC
Active
Other names
Walmart Health
Organization subpart
No
Provider details
NPI number
Authorized official
SOUJANYA PULLURU (PRESIDENT)
(706) 277-7661
Entity
Organization
Contact information
Practice address
815 SHUGART RD, DALTON, GA 30720-2433
(706) 277-7661
(706) 277-7669
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(706) 277-7661
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
07/22/2014
Last updated
11/22/2022
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