VICKSBURG CLINIC LLC (NPI# 1154532257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154532257 |
| Entity Type | Organization |
| Organization Name | VICKSBURG CLINIC LLC |
| Practice Address |
1115 N Frontage Rd Vicksburg MS 39180-5102 |
| Practice Telephone | 6016348790 |
| Mailing Telephone | 6016348790 |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2008-05-07 |
| Authorized Official Name | DEBBIE T BREWER (VP) |
| Authorized Official Telephone | 8778929813 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659307791 | Vicksburg Clinic LLC | Surgery | 1115 N Frontage Rd, Vicksburg, MS 39180-5102 | 2006-06-23 |
| 1619355203 | Vicksburg Clinic LLC | Clinic/Center | 1 Medical Plaza Dr, Vicksburg, MS 39180-5187 | 2015-05-14 |
| 1861622268 | Vicksburg Clinic LLC | Clinic/Center | 2200 Highway 61 N, Vicksburg, MS 39183-8246 | 2009-07-20 |
| 1790915395 | Vicksburg Clinic LLC | Clinic/Center | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2009-07-17 |
| 1528298122 | Vicksburg Clinic LLC | Clinic/Center | 1907 Mission 66, Vicksburg, MS 39180-3711 | 2009-07-17 |
| 1629279054 | Vicksburg Clinic LLC | Internal Medicine | 508 Broadway, Delhi, LA 71232-3002 | 2007-05-31 |
| 1831308816 | Vicksburg Clinic LLC | Internal Medicine | 10 Crothers Dr, Ste. 4, Tallulah, LA 71282-5510 | 2007-05-22 |
| 1992722482 | Vicksburg Clinic LLC | Psychiatry & Neurology | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2006-07-17 |
| 1790711158 | Vicksburg Clinic LLC | Radiology | 1907 Mission 66, Vicksburg, MS 39180-3711 | 2006-06-25 |
| Street Address |
1115 N FRONTAGE RD |
| City | VICKSBURG |
| State | MS |
| Zip Code | 39180-5102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659307791 | Vicksburg Clinic LLC | Surgery | 1115 N Frontage Rd, Vicksburg, MS 39180-5102 | 2006-06-23 |
| 1639259518 | Robert Clifton Strong | Anesthesiology | 1115 N Frontage Rd, Vicksburg, MS 39180-5102 | 2006-10-16 |
| 1992730998 | Rebecca Tustain | Nurse Practitioner | 1115 N Frontage Rd, Vicksburg, MS 39180-5102 | 2006-07-11 |
| 1184655060 | Thomas C Moore | Pediatrics | 1115 N Frontage Rd, Vicksburg, MS 39180-5102 | 2006-07-06 |
| 1861423766 | Philip L Scurria | Psychiatry & Neurology | 1115 N Frontage Rd, Vicksburg, MS 39180-5102 | 2006-07-06 |
| 1831127422 | Gordon W Sluis | Pediatrics | 1115 N Frontage Rd, Vicksburg, MS 39180 | 2006-06-30 |
| 1801824495 | Anita L Tribble | Internal Medicine | 1115 N Frontage Rd, Vicksburg, MS 39180-5102 | 2006-06-30 |
| 1164450755 | Gray Hilsman | Psychiatry & Neurology | 1115 N Frontage Rd, Vicksburg, MS 39180-5102 | 2006-06-30 |
| 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 | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790329183 | Lan Medical | Durable Medical Equipment & Medical Supplies | 12057 W Indian Lake Dr, Vicksburg, MI 49097-9338 | 2019-10-29 |
| 1740682210 | Mississippi Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1435 N. Frontage Rd, Vicksburg, MS 39180-5170 | 2014-09-16 |
| 1316261845 | Magnolia Mobility | Durable Medical Equipment & Medical Supplies | 3109 Washington St, Vicksburg, MS 39180-4968 | 2010-03-26 |
| 1194994434 | Patrick Emeka Igbokwe | Durable Medical Equipment & Medical Supplies | 4798 Highway 61 S, Suite B, Vicksburg, MS 39180-7125 | 2008-02-20 |
| 1487725313 | Lincare Inc | Durable Medical Equipment & Medical Supplies | 2480 S Frontage Rd, Ste F, Vicksburg, MS 39180-5251 | 2006-11-13 |
| 1255437844 | Hometown Medical LLC | Durable Medical Equipment & Medical Supplies | 814 Belmont Street, Vicksburg, MS 39180 | 2006-09-15 |
| 1477662864 | Harco Inc | Durable Medical Equipment & Medical Supplies | 2310 Clay Street, Vicksburg, MS 39183-3123 | 2006-08-29 |
| 1013026400 | K & B Mississippi Corp | Durable Medical Equipment & Medical Supplies | 3046 Indiana Avenue, Vicksburg, MS 39180-5252 | 2006-08-29 |
| 1275548430 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3341 Halls Ferry Rd, Vicksburg, MS 39180-5338 | 2006-07-29 |
| 1982621389 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 2150 Iowa Blvd, Vicksburg, MS 39180-5572 | 2006-07-16 |
| Find all providers in VICKSBURG | ||||
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| 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.