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Organization
DELTA MEDICAL FOUNDATION
Active
Organization
DELTA MEDICAL FOUNDATION
Active
Other names
CLARKSDALE FAM MED CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
LONNIE MOORE (EXECUTIVE DIRECTOR)
(662) 326-3500
Entity
Organization
Contact information
Practice address
1209 LEE DR, CLARKSDALE, MS 38614-3320
(662) 326-3500
(662) 326-7077
Mailing address
PO BOX 289, MARKS, MS 38646-0289
(662) 398-5111
(662) 398-7123
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
NULL
Other
Enumeration date
04/19/2018
Last updated
03/01/2023
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