# DELTA MEDICAL PRACTICES, L.L.C.

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

## Provider details

- **NPI number:** 1871732669
- **Authorized official:** CHARLES GOODWIN GLADNEY JR. (MANAGER)
- **Authorized official phone:** (318) 281-0078

## Contact information

- **Practice address:** 510 S WASHINGTON ST, BASTROP, LA 71220-5033
- **Practice address phone:** (318) 556-3333
- **Mailing address:** 1523 TEXAS AVE, BASTROP, LA 71220-4043

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/18/2009
- **Last updated:** 02/18/2009