Vicksburg Clinic Llc

LBN: Vicksburg Clinic Llc
Vicksburg Clinic Llc is an health care organization with primary practice located at 2100 Highway 61 N , Vicksburg MS 39183-8211. The organization recently has 9 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Gastroenterology, Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Vicksburg Clinic Llc can be contacted via phone (601) 883-5000, or through Brewer, Debbie T via phone (877) 892-9813.

Contact Information

Primary practice address
2100 Highway 61 N Vicksburg MS 39183-8211
Phone: (601) 883-5000
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Brewer, Debbie T
Phone: (877) 892-9813

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X
Allopathic & Osteopathic Physicians / Pediatrics 208000000X
Allopathic & Osteopathic Physicians / Neurology 2084N0400X
Allopathic & Osteopathic Physicians / Surgery 208600000X

Profile Details

NPI number 1992722482
LBN Legal business name Vicksburg Clinic Llc
DBA Doing business as
Authorized official Brewer, Debbie T
Entity Organization
Organization subpart 1 No
Enumeration date Jul 17th, 2006
Last updated Jun 9th, 2008 - about 17 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 1992722482 NPPES
Mississippi MEDICAID 09015545
Mississippi MEDICAID 1444618
Mississippi MEDICAID 00720204
Mississippi MEDICAID 09015548

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