Organization
DELTA MEDICAL FOUNDATION
Active
Other names
CLARKSDALE FAM MED CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
LONNIE MOORE (EXECUTIVE DIRECTOR)
(662) 326-3500
Entity
Organization
Contact information
Practice address
1209 LEE DR, CLARKSDALE, MS 38614-3320
(662) 326-3500
(662) 326-7077
Mailing address
PO BOX 289, MARKS, MS 38646-0289
(662) 398-5111
(662) 398-7123
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Enumeration date
04/19/2018
Last updated
03/01/2023
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