Organization
THE DELTA PATHOLOGY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM WESCHE MD (MEDICAL DIRECTOR)
(318) 621-8200
Entity
Organization
Contact information
Practice address
2915 MISSOURI AVE, SHREVEPORT, LA 71109-4327
(318) 364-2000
Mailing address
PO BOX 3780, TUPELO, MS 38803-3780
(318) 841-9523
(318) 841-9551
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1797979
—
LA
Enumeration date
10/10/2005
Last updated
07/02/2020
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