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VICKSBURG ALLERGY AND ASTHMA
NPI 1619140399
Allergy & Immunology in Vicksburg, MS

Active since April 02, 2008
104 MCAULEY DR, VICKSBURG, MS 39183(601) 636-0097(601) 629-9969 Get Directions Write a Review

NPPES record last updated: April 2, 2008. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Vicksburg Allergy And Asthma NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VICKSBURG ALLERGY AND ASTHMA (NPI 1619140399) is a healthcare organization registered as an allergy & immunology in Vicksburg, Mississippi and active in the NPI registry since April 2008. The organization lists Timothy Kerut, President, as its authorized official.

NPPES Registry Identity

NPI1619140399
Entity TypeOrganization
Primary Taxonomy207K00000X
Legal Business NameVICKSBURG ALLERGY AND ASTHMA
Location Address104 MCAULEY DRVicksburg, MS 39183-2825
Mailing Address107 Carlton Place DrVicksburg, MS 39180-1822 · (601) 636-0097 · Fax (601) 629-9969
Phone(601) 636-0097
Fax(601) 629-9969
Organization SubpartNo
Authorized OfficialTimothy KerutPresident · (601) 636-0097
Enumeration DateApril 2, 2008
✔ NPI 1619140399 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAllergy & ImmunologyAllopathic & Osteopathic Physicians
Taxonomy Code207K00000X
License✔ Licensed in MS · 11047
Definition

An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system.

104 MCAULEY DR, Vicksburg, MS 39183
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DANIEL P EDNEY MD
Internal Medicine
104 MCAULEY DR
VICKSBURG, MS 39183
Warren County (601) 638-7271
SUZANNE CHANNELL ATC, LAT, MBA
Specialist/Technologist (Athletic Trainer)
104 MCAULEY DR
VICKSBURG, MS 39183
Warren County (601) 883-6309
FRANCINE F JOHNSON RD
Dietitian, Registered
104 MCAULEY DR
VICKSBURG, MS 39183
Warren County (601) 619-3610
MIRANDA R MCCASKILL AUD
Audiologist
104 MCAULEY DR
VICKSBURG, MS 39183
Warren County (601) 883-3320
DIABETIC SHOE SOURCE
Durable Medical Equipment & Medical Supplies
104 MCAULEY DR
VICKSBURG, MS 39183
Warren County (601) 883-3342
STEPHANIE FAY PHELAN
Durable Medical Equipment & Medical Supplies
104 MCAULEY DR
VICKSBURG, MS 39183
Warren County (601) 883-3342
VICKSBURG NEPHROLOGY LLC
Internal Medicine (Nephrology)
104 MCAULEY DR
VICKSBURG, MS 39183
Warren County (601) 738-5549
MOHAMMAD A. AHMED M.D.
Psychiatry & Neurology (Neurology)
104 MCAULEY DR
VICKSBURG, MS 39183
Warren County (601) 638-7271

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vicksburg Allergy And Asthma's NPI number?

The NPI number for Vicksburg Allergy And Asthma is 1619140399. It was assigned to this organization in the NPPES registry on April 2, 2008.

Where is Vicksburg Allergy And Asthma located?

Vicksburg Allergy And Asthma is located at 104 Mcauley Dr, Vicksburg, MS 39183. The listed phone number is (601) 636-0097.

What is Vicksburg Allergy And Asthma's specialty?

The primary specialty registered for this NPI is Allergy & Immunology with taxonomy code 207K00000X.

When was this NPI record last updated?

The NPPES record for Vicksburg Allergy And Asthma was last updated on April 2, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.