DELTA NEUROLOGY CLINIC, PLLC (NPI# 1255580049) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255580049 |
| Entity Type | Organization |
| Organization Name | DELTA NEUROLOGY CLINIC, PLLC |
| Practice Address |
785 Ohio Ave Suite 2c Clarksdale MS 38614-6217 |
| Practice Telephone | 6626272544 |
| Practice Fax Number | 6626272052 |
| Mailing Telephone | 6626272544 |
| Mailing Fax Number | 6626272052 |
| Enumeration Date | 2008-09-16 |
| Last Update Date | 2014-01-06 |
| Authorized Official Name | DR. M FASEEH HADIDI (OWNER) |
| Authorized Official Telephone | 6626272544 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
17427 | MS | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00124811 | 05 | |
| AR | 154530001 | 05 |
| Street Address |
785 OHIO AVE SUITE 2C |
| City | CLARKSDALE |
| State | MS |
| Zip Code | 38614-6217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215929104 | Thomas E Weldon | Urology | 785 Ohio Ave, Suite 3e, Clarksdale, MS 38614-6217 | 2005-08-17 |
| 1386184554 | Clarksdale Regional Physicians, LLC | Family Medicine | 785 Ohio Ave, Suite 3g, Clarksdale, MS 38614 | 2017-03-07 |
| 1417309519 | Kathryn Carter | Specialist/Technologist | 785 Ohio Ave, Suite 1h, Clarksdale, MS 38614-6217 | 2016-07-13 |
| 1568814655 | Sherrica Sherrell Smith | Nurse Practitioner | 785 Ohio Ave, Suite 3e, Clarksdale, MS 38614-6217 | 2016-07-13 |
| 1679985493 | Kalilah Kemp | Specialist/Technologist | 785 Ohio Ave, Suite 1h, Clarksdale, MS 38614-6217 | 2014-05-28 |
| 1700125002 | Valerie Orcutt Antici | Nurse Practitioner | 785 Ohio Ave, Suite 1d, Clarksdale, MS 38614-6217 | 2013-02-06 |
| 1811278138 | Janet Dillon | Dietitian, Registered | 785 Ohio Ave, Suite 2f, Clarksdale, MS 38614-6217 | 2011-08-31 |
| 1881827186 | Dorothy L Booker | Dietitian, Registered | 785 Ohio Ave, Suite 2f, Clarksdale, MS 38614-6217 | 2009-09-02 |
| 1487884938 | Carrie Cope Melton | Nurse Practitioner | 785 Ohio Ave, Suite 1d, Clarksdale, MS 38614-6217 | 2009-07-17 |
| 1679714091 | Andrea L. Smith Md | Internal Medicine | 785 Ohio Ave, Suite 1d, Clarksdale, MS 38614-6217 | 2009-03-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386265627 | Lillie Mae Lockett | Technician | 1025 Ritchie Ave, Clarksdale, MS 38614 | 2020-04-28 |
| 1063957751 | Autospa-healthy Youth Center | Nurse Practitioner | 1202 Desoto Ave, Suite A, Clarksdale, MS 38614 | 2017-01-04 |
| 1700226123 | Nikki Nikkia Cager | Internal Medicine | 785 Ohio Ave Ste 2d, Clarksdale, MS 38614 | 2013-06-29 |
| 1205186947 | Celestial Comfort Care Hospice | Hospice Care, Community Based | 110 Yazoo Ave. Suite 212, Clarksdale, MS 38614 | 2012-09-10 |
| 1063667129 | The Smile Center of Clarksdale | Clinic/Center | 526 Choctaw Street, Suites B & C, Clarksdale, MS 38614 | 2008-11-17 |
| 1801060033 | Clarksdale Municipal School District | Local Education Agency (LEA) | Gycelle Tynes Educational Center, Friars Point Road, Clarksdale, MS 38614 | 2008-04-18 |
| 1184806150 | Mary A Williams | Nurse Practitioner | 125 Highway 322, Clarksdale, MS 38614 | 2007-12-03 |
| 1114040367 | William F Wilson Jr. | Dentist | 850 Desoto Ave, Extended, Clarksdale, MS 38614 | 2007-04-10 |
| 1952434920 | Kathleen Tinnel | Nurse Practitioner | 2245 N State St, Clarksdale, MS 38614 | 2007-03-13 |
| 1497888457 | Carole L Mangrem | Pediatrics | 2245 N Starte St, Clarksdale, MS 38614 | 2007-03-13 |
| Find all providers in zip 38614 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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| 1841646148 | Hooks Diabetes & Medicine Clinic, Pllc | Clinic/Center | 2625 Traceland Dr Ste A, Tupelo, MS 38801-4240 | 2016-05-05 |
| 1194060350 | Stewart Ear Sinus & Allergy Pllc | Clinic/Center | 4 Professional Plaza, Starkville, MS 39759 | 2012-11-29 |
| 1912200460 | Amory Hma Physician Mgmt LLC | Clinic/Center | 607 Earl Frye Blvd # A, Amory, MS 38821-5503 | 2010-12-06 |
| 1205146719 | Voulters Medical Consulting | Clinic/Center | 927 E Scenic Dr, Pass Christian, MS 39571-4701 | 2010-10-18 |
| 1629393491 | Soma Plastic Surgery and Hand Clinic | Clinic/Center | 2630 Courthouse Cir Ste A, Flowood, MS 39232-9562 | 2010-04-05 |
| 1750513818 | Magnolia Addiction Treatment Services | Clinic/Center | 500 E Woodrow Wilson Ave Ste D, Jackson, MS 39216-4538 | 2009-08-21 |
| 1598911877 | George E. Wilkerson, M.d., P.a. | Clinic/Center | 348 Crossgates Blvd Ste 2300, Brandon, MS 39042-2634 | 2008-08-18 |
| 1174798334 | Don S Davis Md Pa | Clinic/Center | 5002 Hwy 39 N Bldg A, Meridian, MS 39301-1078 | 2008-04-28 |
| 1346424819 | North Mississippi Vascular Center, Pa | Clinic/Center | 1040a S Madison St, Tupelo, MS 38801-6300 | 2007-12-19 |
| Find all providers with the same taxonomy | ||||
| City | CLARKSDALE |
| Zip Code | 38614 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.