Vicksburg Clinic Llc is a Allergy & Immunology (Allergy) Clinic in Vicksburg, Mississippi. It is situated at 1115 N Frontage Rd, Vicksburg and its contact number is 601-634-8790. The authorized person of Vicksburg Clinic Llc is Debbie T Brewer
who is Director Of Provider Enrollment of the clinic and their contact number is 877-892-9813.
Complete Clinic Profile:
Vicksburg Clinic Llc Clinic speciality, address, contact phone number and fax are as below.
Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
Specialization:
Allergy, Allergy & Immunology
Clinic Address:
1115 N Frontage Rd, Vicksburg, Mississippi, 39180-5102
Phone:
601-634-8790
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Debbie T Brewer
Position:
Director Of Provider Enrollment
Contact Number:
877-892-9813
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Vicksburg Clinic Llc Clinic are as mentioned below.
NPI Number:
1659307791
NPI Enumeration Date:
23 Jun, 2006
NPI Last Update On:
25 Nov, 2008
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Vicksburg Clinic Llc are as mentioned below.
Specialization
License Number
State
Status
Internal Medicine (Infectious Disease)
Primary
Allergy
Secondary
Family Medicine
Secondary
Internal Medicine
Secondary
Cardiovascular Disease
Secondary
Pulmonary Disease
Secondary
Obstetrics
Secondary
Orthopaedic Surgery
Secondary
Pediatrics
Secondary
Neurology
Secondary
Surgery
Secondary
Urology
Secondary
Nurse Practitioner
Secondary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
09015545
Medicaid
Mississippi
09015549
Medicaid
Mississippi
09015546
Medicaid
Mississippi
09015547
Medicaid
Mississippi
1111716
Medicaid
Louisiana
00720204
Medicaid
Mississippi
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Vicksburg Clinic Llc 1115 N Frontage Rd, Vicksburg, Mississippi
Zip:
39180-5102
Phone Number:
601-634-8790
Patients can reach Vicksburg Clinic Llc at 1115 N Frontage Rd, Vicksburg, Mississippi or can call to book an appointment on 601-634-8790. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 March, 2024.
Comments/ Reviews:
Allergy & Immunology (Allergy): Definition to come...
Similar Clinics in Vicksburg, MS
Vicksburg Hma Physician Management Llc Speciality:Internal Medicine Clinic Address: 2080 S Frontage Rd, Suite 100, Vicksburg, MS Phone: 601-262-1000 Fax: 601-262-1009