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Organization

DELTA SURGERY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PETER K.H. GO M.D. (MEDICAL DOCTOR)
(870) 382-1680
Entity
Organization

Contact information

Practice address
811 HIGHWAY 65 S, DUMAS, AR 71639-3006
(870) 382-4303
Mailing address
105 CARLTON DR, DUMAS, AR 71639-2836
(870) 382-1680

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102107001
AR
01
14161000001
QUAL CHOICE
AR
01
57660
BLUE CROSS
AR
Enumeration date
08/28/2009
Last updated
08/28/2009
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