| Delta Physician Practices | |
|
1727 E Union St Greenville MS 38703-3253 | |
| (662) 332-0373 | |
| (662) 332-0375 |
| Full Name | Delta Physician Practices |
|---|---|
| Speciality | Family Medicine |
| Location | 1727 E Union St, Greenville, Mississippi |
| Authorized Official Name and Position | Iris Stacker (CEO) |
| Authorized Official Contact | 6623783783 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Delta Physician Practices Po Box 23998 Jackson MS 39225-3998 Ph: (662) 725-2749 | Delta Physician Practices 1727 E Union St Greenville MS 38703-3253 Ph: (662) 332-0373 |
| NPI Number | 1518086537 |
|---|---|
| Provider Enumeration Date | 03/29/2007 |
| Last Update Date | 11/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518086537 | NPI | - | NPPES |
| 09015100 | Medicaid | MS | |
| 156272002 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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