Provider Demographics
NPI:1508010489
Name:DR. STEVEN DELIA MD PLLC
Entity Type:Organization
Organization Name:DR. STEVEN DELIA MD PLLC
Other - Org Name:DELIA MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DELIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-790-2292
Mailing Address - Street 1:204 E CHOCTAW AVE
Mailing Address - Street 2:
Mailing Address - City:SALLISAW
Mailing Address - State:OK
Mailing Address - Zip Code:74955-4604
Mailing Address - Country:US
Mailing Address - Phone:918-790-2292
Mailing Address - Fax:918-790-2291
Practice Address - Street 1:204 E CHOCTAW AVE
Practice Address - Street 2:
Practice Address - City:SALLISAW
Practice Address - State:OK
Practice Address - Zip Code:74955-4604
Practice Address - Country:US
Practice Address - Phone:918-790-2292
Practice Address - Fax:918-790-2291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK22941207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty