| NPI | 1174642144 |
|---|---|
| Other Name | DELTA HEALTH-GREENVILLE MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | IRIS STACKER CEO 662-725-2264 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2022-11-04 |