VICKSBURG MEDICAL TEAMS MHT LLC (NPI# 1023419801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023419801 |
| Entity Type | Organization |
| Organization Name | VICKSBURG MEDICAL TEAMS MHT LLC |
| Practice Address |
2080 S Frontage Rd Suite 100 Vicksburg MS 39180-5328 |
| Mailing Address |
1515 Heritage Drive Suite 110 Mckinney TX 75069-3379 |
| Practice Telephone | 6015295466 |
| Mailing Telephone | 8174707377 |
| Mailing Fax Number | 8773433192 |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2015-01-02 |
| Authorized Official Name | SAM PIERCE (OWNER/PRESIDENT) |
| Authorized Official Telephone | 6012621000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
2080 S FRONTAGE RD SUITE 100 |
| City | VICKSBURG |
| State | MS |
| Zip Code | 39180-5328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497710685 | Jeffrey Morris | Internal Medicine | 2080 S Frontage Rd, Suite 100, Vicksburg, MS 39180-5328 | 2006-04-19 |
| 1477915718 | Johanna Kimberl | Physician Assistant | 2080 S Frontage Rd, Suite 100, Vicksburg, MS 39180-5328 | 2016-03-25 |
| 1114387123 | Baleigh Ford | Physician Assistant | 2080 S Frontage Rd, #100, Vicksburg, MS 39180-5328 | 2016-03-03 |
| 1134593361 | Robert C. Clingan, Md, Dermatology | Clinic/Center | 2080 S Frontage Rd, Suite 113, Vicksburg, MS 39180-5328 | 2015-11-27 |
| 1508278177 | Medical Associates of Vicksburg Pllc | Internal Medicine | 2080 S Frontage Rd, Vicksburg, MS 39180-5328 | 2014-05-29 |
| 1700210432 | Raymond Patrick Blythe | Nurse Practitioner | 2080 S Frontage Rd, Suite 100, Vicksburg, MS 39180-5328 | 2013-08-29 |
| 1497188460 | Vicksburg Hma Physician Mgmt | Nurse Practitioner | 2080 S Frontage Rd, Ste 100, Vicksburg, MS 39180-5328 | 2013-08-14 |
| 1720372345 | River Oaks Management Company, LLC | Otolaryngology | 2080 S Frontage Rd, Vicksburg, MS 39180-5328 | 2011-05-31 |
| 1659503878 | Battlefield Compounding Center Incorporated | Pharmacy | 2080 S Frontage Rd, Suite 101a, Vicksburg, MS 39180-5328 | 2009-08-21 |
| 1740412964 | Battlefield Express Drugs Incorporated | Pharmacy | 2080 S Frontage Rd, Suite 101, Vicksburg, MS 39180-5328 | 2009-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255877346 | Elite Performance and Rehab, LLC | Clinic/Center | 1901 A Mission 66, Vicksburg, MS 39180 | 2017-01-12 |
| 1679931083 | Heather M Anderson | Physician Assistant | 2080 S Frontage Rd Ste 100, Vicksburg, MS 39180 | 2016-02-01 |
| 1245604941 | Warren County Assn.for Retarded Citizens, Inc. | Day Training, Developmentally Disabled Services | 100 Smokey Lane, Vicksburg, MS 39180 | 2015-11-18 |
| 1386012904 | Brian Oliver Snowden | Counselor | 3530 Manor Dr Ste 5a, Vicksburg, MS 39180 | 2015-09-14 |
| 1962802710 | Jordan P. Crocker, D.m.d., Pllc | Clinic/Center | 109 Monument Place, Vicksburg, MS 39180 | 2014-08-29 |
| 1821434259 | Trisha Addison | Physical Therapist | 2222 South Frontage Road, Suite D, Vicksburg, MS 39180 | 2013-05-13 |
| 1073862157 | Laura Jeanne Briggs | Physical Therapist | 1901-a Mission 66, Vicksburg, MS 39180 | 2012-09-05 |
| 1912175258 | Andrea T. Harris | Counselor | Warren-yazoo Mental Health Service, 3444 Wisconsin Ave., Vicksburg, MS 39180 | 2008-02-20 |
| 1922217314 | Austin Family Dentistry | Dentist | 3040 Indiana Ave, Vicksburg, MS 39180 | 2007-05-22 |
| 1063539138 | Ollie Hardaway Jr. | Dentist | 154 Cottonwood Street, Vicksburg, MS 39180 | 2007-03-23 |
| Find all providers in zip 39180 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831540350 | Evan Fitzgerald | Family Medicine | 13320 North Blvd, Vicksburg, MI 49097-1514 | 2016-06-27 |
| 1861772105 | First Intermed Corporation | Family Medicine | 4204 Clay Street, Vicksburg, MS 39183-0000 | 2011-08-18 |
| 1912933672 | Lara J Teal Clement | Family Medicine | 710 Newitt Vick Dr, Vicksburg, MS 39183-8746 | 2006-06-24 |
| 1184669798 | George Abraham | Family Medicine | 1907 Mission 66, Vicksburg, MS 39180-3711 | 2006-06-18 |
| 1417999301 | Markus B Stanley | Family Medicine | 110 King Arthurs Rdg, Vicksburg, MS 39180-9767 | 2006-06-12 |
| 1386648244 | David J Schriemer | Family Medicine | 13320 N Boulevard St, Vicksburg, MI 49097-1514 | 2005-06-09 |
| 1922633916 | Physician Management Services of Mississippi, LLC | Family Medicine | 1901 Mission 66, Vicksburg, MS 39180-3711 | 2020-03-10 |
| 1417410911 | Cal-med LLC | Family Medicine | 1901 Mission 66, Vicksburg, MS 39180-3711 | 2019-04-11 |
| 1649755208 | Mea Primary Care Plus, LLC | Family Medicine | 4204 Clay St, Vicksburg, MS 39183-3438 | 2018-09-30 |
| 1215373139 | Robert Michael Cannon | Family Medicine | 1901 Mission 66, Vicksburg, MS 39180-3711 | 2013-05-18 |
| Find all providers in VICKSBURG | ||||
Please comment or provide details below to improve the information on VICKSBURG MEDICAL TEAMS MHT LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.