Organization

Delta Medical Group

Legal Business Name

Delta Medical Group

NPI Number

1790701134

NPI Type

Organization

Enumeration Date

07/15/2006

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 1734
1693 FAIRGROUNDS RD

City

Greenville
Greenville

State

MS
MS

Postal Code

38702-1734
38703-7810

Country

US
US

Telephone Number

(662) 725-2749
(662) 725-2749

Authorized Official

Name

Iris Stacker

Title or Position

CEO

Telephone Number

(662) 378-3783

Identifiers

Identifier

156272002
09015100

Identifier State

AR
MS

Identifier Issuer

Unknown
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 11/14/2022

Provider Address