Sidney A Johnson Jr.
VICKSBURG CLINIC LLC


Address: 2368 Grove St, Vicksburg, MS 39183-2857
Phone: 6016383005

Sidney A Johnson Jr. (NPI# 1497757603, PAC ID# 8022142405) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is RADIATION ONCOLOGY.

Physician Overview

Nation Provider ID (NPI) 1497757603
PAC ID by PECOS 8022142405
Professional Enrollment ID I20100820000514
Full Name Sidney A Johnson Jr.
Organization Legal Name VICKSBURG CLINIC LLC
Address 2368 Grove St
Vicksburg
MS 39183-2857
Phone Number 6016383005
Gender M
Medical School UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Graduation Year 1984
Primary Specialty RADIATION ONCOLOGY
Group Practice PAC ID 5890696330
Number of Group Practice Members 30
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
250048 ST DOMINIC-JACKSON MEMORIAL HOSPITAL
250031 MERIT HEALTH RIVER REGION

Other Locations

Address Phone Organization
1850 Chadwick Dr, Jackson, MS 39204-3404 6013732074 RADIATION ONCOLOGY OF MISSISSIPPI PA
2969 Curran Dr N, St. Dominic Cancer Center, Jackson, MS 39216-4121 6012003070 RADIATION ONCOLOGY OF MISSISSIPPI PA
2368 Grove St, Vicksburg, MS 39183-2857 6016383005 VICKSBURG CLINIC LLC

Organization Information

Organization Legal Name VICKSBURG CLINIC LLC
Physicians 31

Physicians with the same organization

Name Specialty Organization Address
Laura Lavee Burris Physician Assistant Vicksburg Clinic LLC 21 S 4th St B, Merit Health Rr Specialist, Rolling Fork, MS 39159-5146
Carrie Willis Eure Physician Assistant Vicksburg Clinic LLC 104 Mcauley Dr, Vicksburg, MS 39183-2825
Gwendolyn J Stewart Nurse Practitioner Vicksburg Clinic LLC 1907 Mission, Suite 66, Vicksburg, MS 39180-3711
Daniel J Silvio Physician Assistant Vicksburg Clinic LLC 1111 N Frontage Rd, Vmc Adolescent Psy Unit Ip, Vicksburg, MS 39180-5102
Alfred G Windham Otolaryngology Vicksburg Clinic LLC 2200 Hwy 61 N 2100, Vicksburg Street Clinic Pediatrics, Vicksburg, MS 39183-8246
Murray P Whitaker Internal Medicine Vicksburg Clinic LLC 54 Sergeant Prentiss Dr, Natchez, MS 39120-4726
Kerrie Kashaun Sanders Nurse Practitioner Vicksburg Clinic LLC 1 Medical Plaza Dr, Vicksburg, MS 39180-5187
Eugene B Ferris General Surgery Vicksburg Clinic LLC 54 Sergeant Prentiss Dr, Natchez, MS 39120-4726
Joyce Wanjugu Muruthi Obstetrics/gynecology Vicksburg Clinic LLC 104 Mcauley Dr, Vicksburg, MS 39183-2825
Henry M Jarmon General Surgery Vicksburg Clinic LLC 54 Sergeant Prentiss Dr, Natchez, MS 39120-4726

Office Location

Street Address 2368 GROVE ST
City VICKSBURG
State MS
Zip 39183-2857

Physicians in the same location

Name Specialty Organization Address
Elizabeth L Herrington Internal Medicine Jackson Oncology Associates 2368 Grove St, Vicksburg, MS 39183-2857
Steven Zachow Radiation Oncology Vicksburg Clinic LLC 2368 Grove St, Vicksburg, MS 39183-2857
Lori C Brent Nurse Practitioner Jackson Oncology Associates 2368 Grove St, Vicksburg, MS 39183-2857
David Wahl Radiation Oncology Vicksburg Oncology Associates LLC 2368 Grove St, Vicksburg, MS 39183-2857

Physicians in the same zip code

Name Specialty Organization Address
Tabitha Nicole Allen Nurse Practitioner Wound Care Associates LLC 2100 Hwy 61 N, Promise Hosp, Vicksburg, MS 39183
Natasha Yvonneavion West Nurse Practitioner Wound Care Associates LLC 2100 Hwy 61 N, Promise Hosp, Vicksburg, MS 39183
Kelly W Ryder Internal Medicine Vicksburg Healthcare LLC 2100 Hwy 61 N, Vicksburg, MS 39183
Annette Bryant Clinical Social Worker 1107 B Openwood St, Vicksburg, MS 39183-2533
Michelle D Banks Nurse Practitioner 919 Mission, Suite 66, Vicksburg, MS 39183-2751
Mary C Strong Nurse Practitioner Vicksburg Holistic Healthcare LLC 919 Mission, Suite 66, Vicksburg, MS 39183-2751
Carrie Willis Eure Physician Assistant Vicksburg Clinic LLC 104 Mcauley Dr, Vicksburg, MS 39183-2825
Joyce Wanjugu Muruthi Obstetrics/gynecology Vicksburg Clinic LLC 104 Mcauley Dr, Vicksburg, MS 39183-2825
Kent Ian Kossoy General Surgery Vicksburg Clinic LLC 104 Mcauley Dr, Vicksburg, MS 39183-2825
Feras M Hamadeh Internal Medicine Vicksburg Clinic LLC 104 Mcauley Dr, Vicksburg, MS 39183-2825
Find all physicians in zip 39183

Competitor

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City VICKSBURG
Zip Code 39183
Specialty RADIATION ONCOLOGY
City + Specialty VICKSBURG + RADIATION ONCOLOGY

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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