NORTH DELTA MEDICINE CLINIC P A

CLARKSDALE, MS
NPI1780778571
Entity TypeOrganization
Authorized ContactKENNETH WAYNE KELLOUGH
Owner
662-621-2192
Organization Subpart ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: MS  16776)
Enumeration Date2006-10-03
Last Update Date2009-12-03
Business Address
NORTH DELTA MEDICINE CLINIC P A
705 N STATE ST
CLARKSDALE, MS 38614-6519
Phone number: 662-621-2192
Mailing Address
NORTH DELTA MEDICINE CLINIC P A
PO BOX 1930
CLARKSDALE, MS 38614-7930
Phone number: 662-621-2192
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