Organization
DELTA ASTHMA & ALLERGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLENE B BROOME MD (OWNER)
(662) 378-2762
Entity
Organization
Contact information
Practice address
2335 HIGHWAY 1 S, GREENVILLE, MS 38701-8337
(662) 378-2762
(662) 378-9573
Mailing address
2335 HIGHWAY 1 S, GREENVILLE, MS 38701-8337
(662) 378-2762
(662) 378-9573
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
12482
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015689
—
MS
01
—
587763099
TRICARE
MS
01
—
587763099B
BLUE CROSS OF MS
MS
Enumeration date
05/30/2007
Last updated
07/01/2010
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