NPI 1598049264

Delta Concierge Medicine, INC.

Organisation Health Maintenance Organization Clarksdale, MS

Practice location

Address: 705 N State St, Clarksdale, MS 38614-6519
Phone: (662) 621-2192
Mailing address: PO Box 1930, Clarksdale, MS 38614-7930

Authorised official

Name: Kenneth Kellough
Title: Chief Executive Officer
Phone: (662) 621-2192

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence 16776 (MS)

Other Health Maintenance Organization providers in Mississippi →

Registry record

NPI: 1598049264
Entity type: Organization
NPI issued: 29 Sep 2011
Record last updated: 29 Sep 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.