Organization
DELTA KIDNEY ALLIANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA HEARN (PRACTICE MANAGER)
(662) 335-4105
Entity
Organization
Contact information
Practice address
1997 N MEDICAL PARK DR, GREENVILLE, MS 38703-7268
(662) 335-4105
(662) 378-2879
Mailing address
1997 MEDICAL PARK DR, GREENVILLE, MS 38703-7268
(662) 335-4105
(662) 378-2879
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
12/17/2018
Last updated
09/14/2020
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