Organization
DELTA MEDICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DORIS MITCHELL (PRESIDENT/CEO)
(318) 459-1600
Entity
Organization
Contact information
Practice address
1800 BUCKNER ST STE B210, SHREVEPORT, LA 71101-4438
(318) 459-1600
Mailing address
1800 BUCKNER STREET STE B210, SHREVEPORT, LA 71101
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
11385
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1368431
—
LA
Enumeration date
03/04/2008
Last updated
03/10/2008
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