| Delta Ob-gyn Clinic | |
|
110 E Baker St Suite A Indianola MS 38751-2451 | |
| (662) 887-7081 | |
| (662) 887-3920 |
| Full Name | Delta Ob-gyn Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 110 E Baker St, Indianola, Mississippi |
| Authorized Official Name and Position | Harold J Blessitt (HOSPITAL ADMINISTRATOR) |
| Authorized Official Contact | 6628877081 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Delta Ob-gyn Clinic 110 E Baker St Suite A Indianola MS 38751-2451 Ph: (662) 887-7081 | Delta Ob-gyn Clinic 110 E Baker St Suite A Indianola MS 38751-2451 Ph: (662) 887-7081 |
| NPI Number | 1023050564 |
|---|---|
| Provider Enumeration Date | 06/11/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023050564 | NPI | - | NPPES |
| 06150805 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 11-1102 (Mississippi) | Primary |
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