Provider Demographics
NPI:1275635674
Name:DELANEY CLINIC PROFESSIONAL ASSOCIATION
Entity Type:Organization
Organization Name:DELANEY CLINIC PROFESSIONAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:LUCIO
Authorized Official - Middle Name:N
Authorized Official - Last Name:MARGALLO
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:605-996-5553
Mailing Address - Street 1:1115 EAST 5TH
Mailing Address - Street 2:
Mailing Address - City:MITCHELL
Mailing Address - State:SD
Mailing Address - Zip Code:57301-1003
Mailing Address - Country:US
Mailing Address - Phone:605-996-5553
Mailing Address - Fax:605-996-1213
Practice Address - Street 1:1115 EAST 5TH
Practice Address - Street 2:
Practice Address - City:MITCHELL
Practice Address - State:SD
Practice Address - Zip Code:57301-1003
Practice Address - Country:US
Practice Address - Phone:605-996-5553
Practice Address - Fax:605-996-1213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty