Delta State University

NPI #1730467648 in Cleveland, Mississippi

Provider Information

NPI Number: 1730467648
Entity Type: Organization
Organization Name: Delta State University
Primary Specialty: Internal Medicine
Enumeration Date: Jul 26, 2011
Last Updated: Oct 4, 2021

Practice Location

Address: 1003 W SUNFLOWER RD
City: Cleveland
State: Mississippi
ZIP Code: 38733-0001
Phone: (662) 846-4280

Authorized Official

Name: ABBY HAVARD, LAT
Title: ASSISTANT AD/HEALTH & PERFROMANCE
Phone: (662) 846-4280

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist - Athletic Trainer — Athletic Trainer	2255A2300X
Internal Medicine	207R00000X	Primary

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