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NORTH DELTA MEDICINE CLINIC P A
NPI 1780778571
Internal Medicine in Clarksdale, MS

Active since October 03, 2006
705 N STATE ST, CLARKSDALE, MS 38614(662) 621-2192(662) 621-2314 Get Directions Write a Review

NPPES record last updated: December 3, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About North Delta Medicine Clinic P A NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NORTH DELTA MEDICINE CLINIC P A (NPI 1780778571) is a healthcare organization registered as an internal medicine in Clarksdale, Mississippi and active in the NPI registry since October 2006. The organization lists Kenneth Wayne Kellough, Owner, as its authorized official.

NPPES Registry Identity

NPI1780778571
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameNORTH DELTA MEDICINE CLINIC P A
Location Address705 N STATE STClarksdale, MS 38614-6519
Mailing AddressPo Box 1930Clarksdale, MS 38614-7930 · (662) 621-2192 · Fax (662) 621-2314
Phone(662) 621-2192
Fax(662) 621-2314
Organization SubpartNo
Authorized OfficialKenneth Wayne KelloughOwner · (662) 621-2192
Enumeration DateOctober 3, 2006
Last NPPES UpdateDecember 3, 2009
✔ NPI 1780778571 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MS · 16776
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
705 N STATE ST, Clarksdale, MS 38614
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Other Identifiers 1

Medicaid01188776MS

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DELTA CONCIERGE MEDICINE, INC.
Health Maintenance Organization
705 N STATE ST
CLARKSDALE, MS 38614
Coahoma County (662) 621-2192
DR. KENNETH W KELLOUGH M.D.
Internal Medicine
705 N STATE ST
CLARKSDALE, MS 38614
Coahoma County (662) 621-2192
KAYLEA BYRD MCCRAW
Nurse Practitioner (Family)
705 N STATE ST
CLARKSDALE, MS 38614
Coahoma County (662) 627-2973
BYRD FAMILY MEDICAL CLINIC
Clinic/Center (Primary Care)
705 N STATE ST
CLARKSDALE, MS 38614
Coahoma County (662) 627-2973

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is North Delta Medicine Clinic P A's NPI number?

The NPI number for North Delta Medicine Clinic P A is 1780778571. It was assigned to this organization in the NPPES registry on October 3, 2006.

Where is North Delta Medicine Clinic P A located?

North Delta Medicine Clinic P A is located at 705 N State St, Clarksdale, MS 38614. The listed phone number is (662) 621-2192.

What is North Delta Medicine Clinic P A's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

When was this NPI record last updated?

The NPPES record for North Delta Medicine Clinic P A was last updated on December 3, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.