Deloach, Mark A

Deloach, Mark A is an individual health care provider with primary practice located at 16 S Sixth St , Bay Springs MS 39422-9055. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Deloach, Mark A can be contacted via phone (601) 764-4501.

Contact Information

Primary practice address
16 S Sixth St Bay Springs MS 39422-9055
Fax: (601) 764-2310
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 14545 Mississippi

Profile Details

NPI number 1679681894
LBN Legal business name Deloach, Mark A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 28th, 2006
Last updated Jul 21st, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679681894 NPPES
Other 822838 WELLCARE

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