Organization
DELTA FAMILY MEDICAL SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT NEAL SUARES JR. M.D. (OWNER)
(662) 334-8557
Entity
Organization
Contact information
Practice address
1554 S COLORADO ST, GREENVILLE, MS 38703-7219
(662) 334-8557
(662) 334-8565
Mailing address
164 BAYOU RD, GREENVILLE, MS 38701-7731
(662) 334-8557
(662) 334-8565
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
20731
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08506528
—
MS
Enumeration date
03/18/2011
Last updated
11/14/2019
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