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Contact Information

DELTA PHYSICIAN PRACTICES
1693 S COLORADO ST
GREENVILLE, MS38703-7211
 Phone: 662-332-8700
 Fax: 662-332-3005
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for DELTA PHYSICIAN PRACTICES

NPI Number 1598884561
LBN Legal business name DELTA PHYSICIAN PRACTICES
Authorized official IRIS STACKER - (CEO)
Entity Organization
Organization subpart 1 Yes
Enumeration date 03/28/2007
Last updated 11/14/2022 - About 4 years ago
Identifiers
AR Medicaid 156272002
MS Medicaid 09015100
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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