Vicksburg Primary Care Team Inc

LBN: Vicksburg Primary Care Team Inc
Vicksburg Primary Care Team Inc is an health care organization with primary practice located at 1901 Mission 66 , Vicksburg MS 39180-3711. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Vicksburg Primary Care Team Inc can be contacted via phone (601) 636-0097, or through Stanley, Mark via phone (601) 636-0097.

Contact Information

Primary practice address
1901 Mission 66 Vicksburg MS 39180-3711
Phone: (601) 636-0097
Fax: (601) 629-9969
Website:
Map and Directions
Authorized official contact:
Name: Stanley, Mark Doctor of Osteopathy (DO)
Phone: (601) 636-0097

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 13941 Mississippi

Profile Details

NPI number 1982768222
LBN Legal business name Vicksburg Primary Care Team Inc
DBA Doing business as
Authorized official Stanley, Mark Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 21st, 2006
Last updated Aug 22nd, 2020 - about 6 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 1982768222 NPPES
Mississippi MEDICAID 08801241

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