Organization
DELTA GASTROENTEROLOGY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ULRIC DUNCAN M.D. (GASTROENTEROLOGIST)
(662) 280-8222
Entity
Organization
Contact information
Practice address
9140 HIGHWAY 51 N, SOUTHAVEN, MS 38671-1233
(662) 280-8222
(662) 280-5541
Mailing address
9140 HIGHWAY 51 N, SOUTHAVEN, MS 38671-1233
(662) 280-8222
(662) 280-5541
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3000117
TLC
TN
01
—
3050626
BLUECROSS BLUESHIELD
TN
05
—
3729898
—
TN
Enumeration date
01/24/2007
Last updated
04/20/2008
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