MC MEDICAL LLC (NPI# 1356907695) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356907695 |
| Entity Type | Organization |
| Organization Name | MC MEDICAL LLC |
| Practice Address |
3615 Charles Hardy Pkwy Ste 200 Dallas GA 30157-9472 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 4792772500 |
| Mailing Telephone | 4792772500 |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2020-09-29 |
| Authorized Official Name | AMANDA BYNUM (VP, HEALTH AND WELLNESS TRANSFORMAT) |
| Authorized Official Telephone | 4792041258 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| N | 231H00000X | Audiologist | Speech, Language and Hearing Service Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 125 Pavilion Pkwy Ste A, Fayetteville, GA 302144098 | 7704600947 | 7707194395 |
| 137 Willow Ln, Mcdonough, GA 302536574 | 6784322023 | 6784329767 |
| 1438 Dogwood Dr. Se, Conyers, GA 30013 | 7708608544 | |
| 2042 W Spring St, Monroe, GA 306553164 | 7702674175 | |
| 210 Cobb Pkwy S Ste 100, Marietta, GA 300606509 | 7709556836 | |
| 3245 Lawrenceville Suwanee Rd Ste 100, Suwanee, GA 300246541 | 6784825441 | |
| 4221 Atlanta Hwy Ste 101, Loganville, GA 300527316 | 4792040291 | |
| 6435 Bells Ferry Rd Ste 110, Woodstock, GA 301892317 | 7709262606 | 7709264148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518509587 | Mc Medical LLC | Psychologist | 448 West Belmont Drive, Calhoun, GA 30701-3016 | 2019-10-11 |
| Street Address |
3615 CHARLES HARDY PKWY STE 200 |
| City | DALLAS |
| State | GA |
| Zip Code | 30157-9472 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922608629 | Harshadbhai Vinubhai Patel | Pharmacist | 3615 Marietta Highway, Dallas, GA 30157 | 2020-10-30 |
| 1043852627 | Lindsay Sheets | Dentist | 59 Hillside Trce Ste 105, Dallas, GA 30157 | 2019-10-15 |
| 1619459062 | Emily Nicole Koopman | Specialist/Technologist | 399 Powder Creek Way, Dallas, GA 30157 | 2018-09-02 |
| 1073969861 | Rachel Spencer | Physical Therapist | 99 Hillside Trace, Dallas, GA 30157 | 2016-05-11 |
| 1336514827 | Petal Shields | Community Health Worker | 121 Omega Ct, Dallas, GA 30157 | 2015-12-09 |
| 1851797294 | Annette Moncion | Nurse Practitioner | 32 Midland Lane, Dallas, GA 30157 | 2014-11-12 |
| 1003211079 | Melissa Brice | Lactation Consultant, Non-RN | 430 Parson Rd, Dallas, GA 30157 | 2014-11-03 |
| 1104101690 | Jared Alan Lott | Pharmacist | 303 Charlie Watts Blvd, Dallas, GA 30157 | 2011-10-15 |
| 1972888758 | Lisa Nicole Mcentire | Massage Therapist | 119 Fairview Oak Trace, Dallas, GA 30157 | 2011-10-12 |
| 1548570120 | Chad Stough | Physician Assistant | 2713 Marietta Highway, Suite 122, Dallas, GA 30157 | 2010-10-15 |
| Find all providers in zip 30157 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619577392 | Best Americare Visiting Doctors, Inc. | General Practice | 13601 Preston Rd Ste 706w, Dallas, TX 75240-5361 | 2020-10-30 |
| 1659978401 | Instaclinic, LLC | General Practice | 7008 Quartermile Ln, Dallas, TX 75248-1448 | 2020-10-05 |
| 1194345959 | Medplus Physician Group Inc. | General Practice | 8585 N Stemmons Fwy Ste S-105, Dallas, TX 75247-3836 | 2020-04-22 |
| 1598397937 | Jennifer Renee Palomares | General Practice | 12221 Merit Dr Ste 350, Dallas, TX 75251-3233 | 2020-02-04 |
| 1902449333 | Strategic Binary Solutions LLC | General Practice | 13030 Audelia Rd, 2190, Dallas, TX 75243-2471 | 2019-10-17 |
| 1922542075 | Liferestore Md Usa LLC | General Practice | 3910 Gaston Ave Ste 140, Dallas, TX 75246-1523 | 2016-12-08 |
| 1275996860 | Doorstep Procare Management LLC | General Practice | 12035 Shiloh Rd Ste 310, Dallas, TX 75228-1507 | 2016-03-31 |
| 1023490661 | Adjust Physical Medicine Pllc | General Practice | 13450 Inwood Rd Ste 100, Dallas, TX 75244-5324 | 2015-06-19 |
| 1679983480 | Nathaniel Ott | General Practice | 810 Turner Ave, Dallas, TX 75208-3737 | 2014-05-01 |
| 1720427057 | Merritt Bonar Teddlie | General Practice | 7830 Meadow Park Dr, 108, Dallas, TX 75230-4942 | 2013-06-20 |
| Find all providers in DALLAS | ||||
Please comment or provide details below to improve the information on MC MEDICAL LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.