VICKSBURG CLINIC LLC (NPI# 1831308816) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831308816 |
| Entity Type | Organization |
| Organization Name | VICKSBURG CLINIC LLC |
| Practice Address |
10 Crothers Dr Ste. 4 Tallulah LA 71282-5510 |
| Practice Telephone | 3185740056 |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2008-10-01 |
| Authorized Official Name | DEBBIE T BREWER (DIRECTOR OF PROVIDER ENROLLMENT) |
| Authorized Official Telephone | 8778929813 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1444740 | 05 | |
| LA | 1192694 | 05 |
| 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 |
| 1154532257 | Vicksburg Clinic LLC | Durable Medical Equipment & Medical Supplies | 1115 N Frontage Rd, Vicksburg, MS 39180-5102 | 2007-05-24 |
| 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 |
10 CROTHERS DR STE. 4 |
| City | TALLULAH |
| State | LA |
| Zip Code | 71282-5510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902987548 | Madison Parish Service District Hospital | Internal Medicine | 10 Crothers Dr, Tallulah, LA 71282-5510 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982211140 | Adonis Williams | Counselor | 410 E Askew Street, Tallulah, LA 71282 | 2020-09-30 |
| 1154957272 | Renewed Path Counseling Services LLC | Community/Behavioral Health | 602 Wood St Suite A, Richmond, LA 71282 | 2020-03-20 |
| 1639632136 | Ljconsulting & Professional Services, LLC | Counselor | 809 Bailey Rd., Tallulah, LA 71282 | 2019-04-11 |
| 1982120937 | Chryl Smith Lee | Counselor | 1705 W Feliciana Ave, Talullah, LA 71282 | 2017-08-21 |
| 1730619347 | Carmen Larae Allen | Counselor | 805 N Beech Street, Tallulah, LA 71282 | 2017-06-15 |
| 1205365665 | Brittney Vontres Scott | Case Manager/Care Coordinator | 1705 Felicia Avenue, Tallulah, LA 71282 | 2017-06-08 |
| 1427500123 | Sharon Jackson | Case Manager/Care Coordinator | 1000 S Elm St, Tallulah, LA 71282 | 2016-10-28 |
| 1982152989 | John Tanner Mcdonald | Pharmacist | 402 East Darrow Street, Tallulah, LA 71282 | 2016-09-19 |
| 1164874350 | Victor Lewis Jr. | Counselor | 1705 Felicia Drive, Tallulah, LOUISIANA 71282 | 2016-07-12 |
| 1356797492 | Keisha Prosser | Case Manager/Care Coordinator | 1705 Felicia Aveune, Tallulah, LA 71282 | 2016-05-08 |
| Find all providers in zip 71282 | ||||
| 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 |
|---|---|---|---|---|
| 1982962445 | Thomas A. Neumann, Md, A Medical Corporation | Family Medicine | 114 N Cedar St, Tallulah, LA 71282-3811 | 2012-05-02 |
| 1457314494 | Ronald C. Wyche | Family Medicine | 804 N Beech St, Tallulah, LA 71282-3809 | 2006-04-10 |
| 1386779205 | Thomas A. Neumann | Family Medicine | 808 Johnson St, Tallulah, LA 71282-4535 | 2007-02-22 |
| 1134270028 | Lawrence Francis Chenier | Family Medicine | 808 Johnson St, Tallulah, LA 71282-4535 | 2007-01-16 |
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| 1255941498 | Concierge Medical Services | Family Medicine | 4108 Vendome Pl, New Orleans, LA 70125-2739 | 2020-08-03 |
| 1922621390 | Partners In Primary Care La PC | Family Medicine | 7551 Youree Dr Ste 11, Shreveport, LA 71105-5533 | 2020-05-20 |
| 1760005136 | Partners In Primary Care La PC | Family Medicine | 2900 E Texas St Ste 100, Bossier City, LA 71111-3275 | 2020-05-20 |
| 1871116244 | Partners In Primary Care La PC | Family Medicine | 537 Bertrand Dr Ste F0a, Lafayette, LA 70506-5556 | 2020-05-20 |
| 1578185781 | Prestige Medical Staffing and Marketing | Family Medicine | 4108 Vendome Place, New Orleans, LA 70125 | 2020-05-11 |
| 1487275939 | La Health Solutions-laplace LLC | Family Medicine | 1524 W Airline Hwy, La Place, LA 70068-3725 | 2020-05-06 |
| 1316575434 | Southern Healthcare of Louisiana | Family Medicine | 1340 Gause Blvd W, Slidell, LA 70460 | 2020-04-01 |
| 1780219907 | Shirley Ann Burns | Family Medicine | 1201 South St, Vinton, LA 70668-4509 | 2020-03-09 |
| Find all providers with the same taxonomy | ||||
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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.