Organization
DELTA PHYSICIAN PRACTICES
Active
Organization
DELTA PHYSICIAN PRACTICES
Active
Parent organization
DELTA PHYSICIAN PRACTICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
DELTA PHYSICIAN PRACTICES
Authorized official
IRIS STACKER (CEO)
(662) 378-3783
Entity
Organization
Contact information
Practice address
1513 E UNION ST, GREENVILLE, MS 38703-3249
(662) 334-9712
(662) 332-9703
Mailing address
PO BOX 23998, JACKSON, MS 39225-3998
(662) 725-2749
(662) 725-2741
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RI0011X
Interventional Cardiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015100
—
MS
05
—
156272002
—
AR
Enumeration date
03/29/2007
Last updated
11/14/2022
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