Provider Demographics
NPI:1578063111
Name:DELTA JOINT MANAGEMENT, LLC
Entity Type:Organization
Organization Name:DELTA JOINT MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:LUCEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-207-4157
Mailing Address - Street 1:200 W WENDOVER AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1307
Mailing Address - Country:US
Mailing Address - Phone:336-333-6443
Mailing Address - Fax:
Practice Address - Street 1:200 W WENDOVER AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1307
Practice Address - Country:US
Practice Address - Phone:336-333-6443
Practice Address - Fax:336-333-6443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management