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Organization

DELTA ONCOLOGY, INC.

Active
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Organization

DELTA ONCOLOGY, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SYED RAFIQUE MD (PHYSICIAN/OWNER)
(662) 453-3167
Entity
Organization

Contact information

Practice address
333 HIGHWAY 82 W, GREENWOOD, MS 38930-6538
(662) 453-3167
(662) 453-9180
Mailing address
333 HIGHWAY 82 W, GREENWOOD, MS 38930-6538
(662) 453-3167
(662) 453-9180

Taxonomy

Speciality
Code
Description
License number
State
261QX0200X
Oncology Clinic/Center
Primary
14648
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07370553
—
MS
01
—
1871607598
PROVIDER NPI NUMBER
MS
01
—
DU4354
RAILROAD MEDICARE PTAN
—
Enumeration date
05/09/2013
Last updated
09/10/2014
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