# DELTA MEDICAL CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720353618
- **Authorized official:** MRS. PAULA A HIMES CPC (BILLING OFFICE)
- **Authorized official phone:** (504) 392-3392

## Contact information

- **Practice address:** 103 DOCTOR BOWEN ST, BELLE CHASSE, LA 70037-1505
- **Practice address phone:** (504) 392-3392
- **Practice address fax:** (504) 392-3303
- **Mailing address:** 103 DOCTOR BOWEN ST, BELLE CHASSE, LA 70037-1505
- **Mailing address phone:** (504) 392-3392
- **Mailing address fax:** (504) 392-3303

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 025901 | LA | Yes |

## Other

- **Enumeration date:** 03/12/2012
- **Last updated:** 06/25/2012