Delta Medical Practices, L.L.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

DELTA MEDICAL PRACTICES, L.L.C.

Practice address

510 S Washington St
Bastrop, LA 71220-5033

Phone

(318) 556-3333

NPI assigned

Feb 18, 2009

Last updated

Feb 18, 2009By 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

Charles Goodwin Gladney Jr.

Title

Manager

Phone

(318) 281-0078

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234915200000",
    "number": "1871732669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1523 TEXAS AVE",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712204043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S WASHINGTON ST",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712205033",
            "telephone_number": "318-556-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA MEDICAL PRACTICES, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-18",
        "last_updated": "2009-02-18",
        "status": "A",
        "authorized_official_last_name": "GLADNEY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "GOODWIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "318-281-0078",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Hollis Davis, FNP-C
• Ijnanya Davis
• Levi Dejohnette III
• Delta Anesthesia Associates
• Delta Behavioral Health Services
• Department of Health and Hospitals (OBH-Bastrop Addictive Disorders Clinic)
• Department of Health and Hospitals (Bastrop Behavioral Health Clinic)
• DHH Office of Behavioral Health
• Lindsey Lenette Diel, COTA
• Kimberly Dorris, RPH

• Internal Medicine Physician in Bastrop, LA
• Providers in Bastrop, LA by specialty
• Internal Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2009; 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.