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Organization
DELTA PHYSICIAN PRACTICES
Active
Organization
DELTA PHYSICIAN PRACTICES
Active
Parent organization
DELTA PHYSICIAN PRACTICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
DELTA PHYSICIAN PRACTICES
Authorized official
IRIS STACKER (CEO)
(662) 378-3783
Entity
Organization
Contact information
Practice address
1202 HOSPITAL ST, GREENVILLE, MS 38703-3213
(662) 335-6703
(662) 335-6705
Mailing address
PO BOX 23998, JACKSON, MS 39225-3998
(662) 725-2749
(662) 725-2741
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015100
—
MS
05
—
156272002
—
AR
Enumeration date
03/28/2007
Last updated
11/14/2022
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