| Mulberry Primary Care LLC | |
|
831 Auburn Rd Ste 230 Dacula GA 30019-5437 | |
| (678) 232-7332 | |
| (470) 300-1100 |
| Full Name | Mulberry Primary Care LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 831 Auburn Rd Ste 230, Dacula, Georgia |
| Authorized Official Name and Position | Jocilli Walton (FNP) |
| Authorized Official Contact | 6787360460 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mulberry Primary Care LLC 2716 Wildflower Way Hoschton GA 30548-3653 Ph: (678) 736-0460 | Mulberry Primary Care LLC 831 Auburn Rd Ste 230 Dacula GA 30019-5437 Ph: (678) 232-7332 |
| NPI Number | 1689435448 |
|---|---|
| Provider Enumeration Date | 01/18/2024 |
| Last Update Date | 10/03/2024 |
| Certification Date | 10/03/2024 |
| Medicare PECOS PAC ID | 0941646269 |
|---|---|
| Medicare Enrollment ID | O20240308002941 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689435448 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Jocilli F Walton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174089452 PECOS PAC ID: 1850737172 Enrollment ID: I20240308003029 |
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