NPI 1609464619 · live from the CMS NPI Registry
Delta Health System
Internal Medicine in Clarksdale, MS. National Provider Identifier 1609464619, active.
NPI record
| NPI | 1609464619 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Internal Medicine 207R00000X |
| Practice location | 785 Ohio Ave Ste 2h, Clarksdale, MS 38614 |
| Practice phone | 662-627-3003 |
| Mailing address | Po Box 5247, Greenville, MS 38704 |
| Enumerated | January 5, 2021 |
| Last updated | November 14, 2022 |
| Authorized official | Iris Stacker, Chief Executive Officer |
| Other names | Delta Health-Medical Group; Delta Health-Clarksdale Physician Group |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Anesthetist, Certified Registered | 367500000X | — |
| Internal Medicine, Nephrology | 207RN0300X | — |
| Internal Medicine, Pulmonary Disease | 207RP1001X | — |
| Orthopaedic Surgery | 207X00000X | — |
| Pediatrics | 208000000X | — |
| Surgery | 208600000X | — |
| Clinic/Center, Sleep Disorder Diagnostic | 261QS1200X | — |
| Anesthesiology | 207L00000X | — |
| Emergency Medicine | 207P00000X | — |
| Family Medicine | 207Q00000X | — |
| Internal Medicine, Gastroenterology | 207RG0100X | — |
| Internal Medicine primary | 207R00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.