Individual provider · NPI-1
Mark A Deloach, MD
Family Medicine · Bay Springs, MS
NPI number1679681894
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1679681894
- Entity type
- Individual (NPI-1)
- Name
- Mark A Deloach
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 28, 2006
- Last updated
- Jul 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 14545 | MS | Yes |
Practice location
16 S Sixth StBay Springs, MS 39422-9055
Phone 601-764-4501 · Fax 601-764-2310
Mailing address
Po Box 723Bay Springs, MS 39422-0723
Phone 601-340-3544 · Fax 601-651-2926
Other practice locations
5135 Highway 84 W
Laurel, MS 39443
Laurel, MS 39443
Phone 601-340-3544 · Fax 601-651-2926
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