DELTA MEDICAL FOUNDATION NPI 1467949941

NPI Information

  • NPI: 1467949941
  • Provider Name: DELTA MEDICAL FOUNDATION
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: CLARKSDALE FAM MED CENTER
  • CLIA Number: 25D2281590
  • Address: 1209 LEE DR
    CLARKSDALE, MS
    ZIP 38614
  • Phone: (662) 326-3500

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NPI Details

DELTA MEDICAL FOUNDATION is a family medicine in Clarksdale, MS. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DELTA MEDICAL FOUNDATION NPI is 1467949941. The provider is registered as an organization entity type.
The provider Is Doing Business As Clarksdale Fam Med Center.

The provider's business location address is:

1209 LEE DR
CLARKSDALE, MS
ZIP 38614-320
Phone: (662) 326-3500
Fax: (662) 326-7077

The provider's authorized official is Lonnie Moore .
The authorized official title is Executive Director and has the following contact phone number (662) 326-3500.

The CLIA number assigned to this NPI record is 25D2281590 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/19/2018 and was last updated on 3/1/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR1300XClinic/CenterRural HealthNo
2207Q00000XFamily MedicineYes

What is NPI?

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This page was last updated on: 11/21/2025

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