| Delta State University | |
|
1003 W Sunflower Rd Cleveland MS 38733-0001 | |
| (662) 846-4280 | |
| Not Available |
| Full Name | Delta State University |
|---|---|
| Speciality | Internal Medicine |
| Location | 1003 W Sunflower Rd, Cleveland, Mississippi |
| Authorized Official Name and Position | Abby Havard (ASSISTANT AD/HEALTH & PERFROMANCE) |
| Authorized Official Contact | 6628464280 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Delta State University 1003 W Sunflower Rd Cleveland MS 38733-0001 Ph: (166) 284-6428 | Delta State University 1003 W Sunflower Rd Cleveland MS 38733-0001 Ph: (662) 846-4280 |
| NPI Number | 1730467648 |
|---|---|
| Provider Enumeration Date | 07/26/2011 |
| Last Update Date | 10/04/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730467648 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 2255A2300X | Specialist/technologist - Athletic Trainer | (* (Not Available)) | Secondary |
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