Vicksburg Clinic Llc

LBN: Vicksburg Clinic Llc
Vicksburg Clinic Llc is an health care organization with primary practice located at 1115 N Frontage Rd , Vicksburg MS 39180-5102. The organization recently has 13 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Allergy, Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Infectious Disease, Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Obstetrics, Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Urology, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Allopathic & Osteopathic Physicians / Infectious Disease is the primary health care specialty. Vicksburg Clinic Llc can be contacted via phone (601) 634-8790, or through Brewer, Debbie T via phone (877) 892-9813.

Contact Information

Primary practice address
1115 N Frontage Rd Vicksburg MS 39180-5102
Phone: (601) 634-8790
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Brewer, Debbie T
Phone: (877) 892-9813

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy 207KA0200X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X
Allopathic & Osteopathic Physicians / Obstetrics 207VX0000X
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X
Allopathic & Osteopathic Physicians / Pediatrics 208000000X
Allopathic & Osteopathic Physicians / Neurology 2084N0400X
Allopathic & Osteopathic Physicians / Surgery 208600000X
Allopathic & Osteopathic Physicians / Urology 208800000X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X

Profile Details

NPI number 1659307791
LBN Legal business name Vicksburg Clinic Llc
DBA Doing business as
Authorized official Brewer, Debbie T
Entity Organization
Organization subpart 1 No
Enumeration date Jun 23rd, 2006
Last updated Nov 25th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659307791 NPPES
Mississippi MEDICAID 09015545
Mississippi MEDICAID 09015549
Mississippi MEDICAID 09015546
Mississippi MEDICAID 09015547
Mississippi MEDICAID 1111716
Mississippi MEDICAID 00720204

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