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Organization
DELTA HEALTH SYSTEM
Active
Organization
DELTA HEALTH SYSTEM
Active
Parent organization
DELTA HEALTH-THE MEDICAL CENTER
Other names
Delta Health-Medical Group, Delta Health-Clarksdale Physician Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
DELTA HEALTH-THE MEDICAL CENTER
Authorized official
IRIS STACKER (CHIEF EXECUTIVE OFFICER)
(662) 378-3783
Entity
Organization
Contact information
Practice address
785 OHIO AVE STE 2H, CLARKSDALE, MS 38614-6216
(662) 627-3003
Mailing address
PO BOX 5247, GREENVILLE, MS 38704-5247
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
NULL
207L00000X
Anesthesiology Physician
—
—
207P00000X
Emergency Medicine Physician
—
NULL
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0100X
Gastroenterology Physician
—
NULL
207RG0100X
Gastroenterology Physician
—
—
207RN0300X
Nephrology Physician
—
NULL
207RN0300X
Nephrology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
NULL
207RP1001X
Pulmonary Disease Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
NULL
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
—
NULL
367500000X
Certified Registered Nurse Anesthetist
—
NULL
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
01/05/2021
Last updated
11/14/2022
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