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NPI Code Detail

MEDICARE: DELTA MEDICAL SERVICES

MEDICARE: DELTA MEDICAL SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251T00000XPACE Provider Organization11385LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154508364
Entity Type Code : Organization
Provider Name (Legal Business Name) : DELTA MEDICAL SERVICES
Provider Business Mailing Address
First Line : 1800 BUCKNER ST
Second Line : SUITE B210
City : SHREVEPORT
State : LA
Zip : 71101-4440
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1800 BUCKNER ST
Second Line : SUITE B210
City : SHREVEPORT
State : LA
Zip : 71101-4440
Country : US
Telephone Number : 318-459-1600
Fax Number :
Authorized Official
Title or Position : PRESIDENT/CEO
Name : DORIS MITCHELL
Credential :
Telephone Number : 318-459-1600
Provider Enumeration Date : 01/30/2008
Last Update Date : 01/30/2008

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1477548030 — DR. PHILIP J GARAVAGLIA MD
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1437144052 — DR. RAJA I ZABANEH MD,FACP
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1154317469 — DR. MICHAEL D ROKAW MD
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1800 BUCKNER ST , STE C120
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1972599116 — PATRICIA T KENNEDY FNP
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1407842644 — DONALD B SMITH NP
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1679560379 — DR. ROBERT N MCCOY MD
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Practice Fax: 318-222-0407

Directions to “DELTA MEDICAL SERVICES ” Practice Location

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