Provider Demographics
NPI:1215035548
Name:DELK, MARCIA LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:LEE
Last Name:DELK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARCIA
Other - Middle Name:DELK
Other - Last Name:PAYNE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:805 SANDY PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-6340
Mailing Address - Country:US
Mailing Address - Phone:770-792-5018
Mailing Address - Fax:770-792-5033
Practice Address - Street 1:805 SANDY PLAINS RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-6340
Practice Address - Country:US
Practice Address - Phone:770-792-5018
Practice Address - Fax:770-792-5033
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA025142207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine