| Delta Medical Foundation | |
|
551 Medical Dr Clarksdale MS 38614-6733 | |
| (662) 624-2531 | |
| (662) 627-9091 |
| Full Name | Delta Medical Foundation |
|---|---|
| Speciality | Clinic/Center |
| Location | 551 Medical Dr, Clarksdale, Mississippi |
| Authorized Official Name and Position | Lonnie Moore (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6623263500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Delta Medical Foundation Po Box 289 Marks MS 38646-0289 Ph: (662) 398-5111 | Delta Medical Foundation 551 Medical Dr Clarksdale MS 38614-6733 Ph: (662) 624-2531 |
| NPI Number | 1508363060 |
|---|---|
| Provider Enumeration Date | 04/11/2018 |
| Last Update Date | 03/01/2023 |
| Medicare PECOS PAC ID | 2163777046 |
|---|---|
| Medicare Enrollment ID | O20180618001135 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508363060 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Robert Waller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821001041 PECOS PAC ID: 5698745420 Enrollment ID: I20041129000760 |
| Provider Name | Vernon Thomas Hughes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427073170 PECOS PAC ID: 5890713416 Enrollment ID: I20051102000811 |
| Provider Name | Mccarley E Haynes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639551583 PECOS PAC ID: 9739486077 Enrollment ID: I20160331000328 |
| Provider Name | Lonnie L Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962852988 PECOS PAC ID: 8820386451 Enrollment ID: I20161013001187 |
| Provider Name | Jessica Downs Tubbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124574231 PECOS PAC ID: 4587943873 Enrollment ID: I20161109000265 |
| Provider Name | Megan G Carpenter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780157727 PECOS PAC ID: 5193066454 Enrollment ID: I20190415000988 |
| Provider Name | Courtney Renee Fortner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841951928 PECOS PAC ID: 9436543501 Enrollment ID: I20220307001516 |
| Provider Name | Carolyn Oneida O'conner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841076403 PECOS PAC ID: 4981059144 Enrollment ID: I20231009002694 |
| Provider Name | Whitney H Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376243196 PECOS PAC ID: 2365981388 Enrollment ID: I20240822000494 |
Fast Pace Mississippi, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 619 S State St, Clarksdale, MS 38614 Phone: 662-966-1012 | |
Clarksdale Hma Physican Management, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 580 Friars Point Rd, Clarksdale, MS 38614 Phone: 662-624-4316 Fax: 662-621-1151 | |
Aaron E Henry Community Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 510 Highway 322, Clarksdale, MS 38614 Phone: 662-624-4292 Fax: 662-624-4354 | |
Aaron E. Henry Community Health Services Center, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 800 Ohio Ave, Clarksdale, MS 38614 Phone: 662-624-4292 Fax: 662-624-4354 | |
Family First Clinic Of Clarksdale, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1015 Lee Dr, Suite 13, Clarksdale, MS 38614 Phone: 662-592-4170 Fax: 662-269-0226 | |
Aaron E Henry Community Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 510 Highway 322, Clarksdale, MS 38614 Phone: 662-624-4292 Fax: 662-624-4354 | |
Clarksdale Regional Physicians, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 785 Ohio Ave, Suite 3g, Clarksdale, MS 38614 Phone: 662-624-8000 |