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815 Shugart Rd Dalton GA 30720-2433 | |
(706) 277-7661 | |
(706) 277-7669 |
Full Name | |
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Speciality | General Practice |
Location | 815 Shugart Rd, Dalton, Georgia |
Authorized Official Name and Position | Soujanya Pulluru (PRESIDENT) |
Authorized Official Contact | 7062777661 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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702 Sw 8th St Bentonville AR 72716-0445 Ph: (706) 277-7661 | 815 Shugart Rd Dalton GA 30720-2433 Ph: (706) 277-7661 |
NPI Number | 1184031163 |
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Provider Enumeration Date | 07/22/2014 |
Last Update Date | 11/22/2022 |
Identifier | Type | State | Issuer |
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1184031163 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208D00000X | General Practice | (* (Not Available)) | Primary |
363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
I D Specialist Dalton P C Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1200 E Walnut Ave Ste 4, Dalton, GA 30721 Phone: 706-428-8908 | |
The Deo Clinic, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 218 N Fredrick St, Dalton, GA 30721 Phone: 706-581-2009 Fax: 706-529-5055 | |