Organization
DELTA CARDIOVASCULAR CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER D WEINER MD (CEO/PRESIDENT)
(662) 621-1915
Entity
Organization
Contact information
Practice address
520 MEDICAL DR, CLARKSDALE, MS 38614-6732
(662) 621-1915
(662) 621-9022
Mailing address
520 MEDICAL DR, CLARKSDALE, MS 38614-6732
(662) 621-1915
(662) 621-9022
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
16396
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08952038
—
MS
05
—
158639002
—
AR
Enumeration date
10/17/2006
Last updated
06/04/2014
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