MC Medical LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

MC MEDICAL LLC

Practice address

6020 Harrison Rd
Macon, GA 31206-4742

Phone

(478) 703-0468

Fax

(478) 784-9118

NPI assigned

Jul 21, 2014

Organization subpart

No

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

Authorized official

Name

Soujanya Pulluru

Title

President

Phone

(479) 703-0468

Specialties & licenses 2

Addresses

Other names 1

• Walmart Care Clinic 10-1153 Other name

Locations

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638835200000",
    "number": "1285041434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SW 8TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727160445",
            "telephone_number": "479-204-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6020 HARRISON RD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312064742",
            "telephone_number": "478-703-0468",
            "fax_number": "478-784-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MC MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-21",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A",
        "authorized_official_last_name": "PULLURU",
        "authorized_official_first_name": "SOUJANYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "479-703-0468"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walmart Care Clinic 10-1153",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dana Lindsey Mayo, MD
• Ranell M Mays, RPH
• Christina L Mayville, M.D.
• Lesley Sheeley Mazick, PT, DPT, ATC
• Erica MC Ginty, MD
• Charles Michael McAfee, RPH
• Yvonne P McAllister, M.D.
• Brooke McArthur
• Kathryn M. McAteer, MA,CCC/SLP
• Courtney McBroom

• General Practice Physician in Macon, GA
• Providers in Macon, GA by specialty
• General Practice Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.