Delta Diagnostic & Therapeutic Rad

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

R2333 Issued in AR

Legal business name

DELTA DIAGNOSTIC & THERAPEUTIC RAD

Practice address

316 W 6TH Ave
Pine Bluff, AR 71601-4217

Phone

(870) 850-6053

Fax

(870) 850-6482

NPI assigned

Jun 20, 2006

Organization subpart

No

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

Authorized official

Name

Tanya M Simpson

Title

President

Phone

(870) 850-6053

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273708800000",
    "number": "1548206543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 W 6TH AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716014217",
            "telephone_number": "870-850-6053",
            "fax_number": "870-850-6482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 W 6TH AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716014217",
            "telephone_number": "870-850-6053",
            "fax_number": "870-850-6482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA DIAGNOSTIC & THERAPEUTIC RAD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2010-05-13",
        "status": "A",
        "authorized_official_last_name": "SIMPSON",
        "authorized_official_first_name": "TANYA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-850-6053"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AR",
            "license": "R2333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155956002",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BLUE CROSS BLUE SHIELD",
            "identifier": "5C647",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BREAST CARE",
            "identifier": "770218402",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA GROUP",
            "identifier": "DC3930",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dotiana Marnise Dawson
• DC Development PA (Accident & Injury Chiropractic)
• Devon Deden, APRN-CNP
• Jennifer Lynne Dedman, LMSW
• John D Dedman, M.D.
• Matthew Alan Devers, PHARMD
• Carla Devose, APRN
• Shabbir Dharamsey, M.D.
• Holly E Dial, LPN
• Dianne's Adult Health Daycare Center

• Diagnostic Radiology Physician in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Diagnostic Radiology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.