Organization
DELTA ONCOLOGY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SYED RAFIQUE MD (PHYSICIAN/OWNER)
(662) 453-3167
Entity
Organization
Contact information
Practice address
333 HIGHWAY 82 W, GREENWOOD, MS 38930-6538
(662) 453-3167
(662) 453-9180
Mailing address
333 HIGHWAY 82 W, GREENWOOD, MS 38930-6538
(662) 453-3167
(662) 453-9180
Taxonomy
Speciality
Code
Description
License number
State
261QX0200X
Oncology Clinic/Center
Primary
14648
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07370553
—
MS
01
—
1871607598
PROVIDER NPI NUMBER
MS
01
—
DU4354
RAILROAD MEDICARE PTAN
—
Enumeration date
05/09/2013
Last updated
09/10/2014
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