Delta Neurology Clinic, PLLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

17427 Issued in MS

Legal business name

DELTA NEUROLOGY CLINIC, PLLC

Practice address

785 Ohio Ave
Suite 2C
Clarksdale, MS 38614-6217

Phone

(662) 627-2544

Fax

(662) 627-2052

NPI assigned

Sep 16, 2008

Last updated

Jan 6, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. M Faseeh Hadidi, MD

Title

Owner

Phone

(662) 627-2544

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mohamad F Hadidi, M.D.

  • Neurology Physician
  • Clarksdale, MS
  • NPI 1164460101
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388966400000",
    "number": "1255580049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 OHIO AVE",
            "address_2": "SUITE 2C",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386146217",
            "telephone_number": "662-627-2544",
            "fax_number": "662-627-2052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 OHIO AVE",
            "address_2": "SUITE 2C",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386146217",
            "telephone_number": "662-627-2544",
            "fax_number": "662-627-2052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA NEUROLOGY CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-16",
        "last_updated": "2014-01-06",
        "status": "A",
        "authorized_official_last_name": "HADIDI",
        "authorized_official_first_name": "M",
        "authorized_official_middle_name": "FASEEH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-627-2544",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MS",
            "license": "17427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00124811",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154530001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Delta Health System (Delta Health-Medical Group)
• Delta Health System (Delta Health-Northwest Regional)
• Delta Health System (Delta Health-Northwest Regional (RHC))
• Delta Medical Foundation (Clarksdale Fam Med Center)
• Delta Medical Foundation (Warrington Clinic)
• Delta Radiology Associates, PLLC
• Joseph Aaron Dikun, PHARM.D.
• Janet Dillon
• Alvin Clayton Dixon
• Ellen Dorsey, LC

• Medical Specialty Clinic/Center in Clarksdale, MS
• Providers in Clarksdale, MS by specialty
• Medical Specialty Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.