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VICKSBURG CLINIC LLC
NPI 1629279054
Surgery in Vidalia, LA

Active since May 31, 2007
107 FRONT ST STE 1200, VIDALIA, LA 71373(318) 336-2220(318) 336-6060 Get Directions Write a Review

NPPES record last updated: February 14, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Vicksburg Clinic Llc NPPES

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

VICKSBURG CLINIC LLC (NPI 1629279054) is a healthcare organization registered as a surgery in Vidalia, Louisiana and active in the NPI registry since May 2007. The organization lists Kristy Music, Director Provider Enrollment, as its authorized official.

NPPES Registry Identity

NPI1629279054
Entity TypeOrganization
Primary Taxonomy208600000X
Legal Business NameVICKSBURG CLINIC LLC
Location Address107 FRONT ST STE 1200Vidalia, LA 71373-2834
Mailing Address508 BroadwayDelhi, LA 71232-3002 · (318) 878-3737
Phone(318) 336-2220
Fax(318) 336-6060
Organization SubpartNo
Authorized OfficialKristy MusicDirector Provider Enrollment · (615) 465-7377
Enumeration DateMay 31, 2007
Last NPPES UpdateFebruary 14, 2025
NPPES CertifiedFebruary 14, 2025
✔ NPI 1629279054 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedObstetrics & GynecologyTaxonomy 207V00000X
Also ListedUrologyTaxonomy 208800000X
Also ListedGeneral PracticeTaxonomy 208D00000X
107 FRONT ST STE 1200, Vidalia, LA 71373
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Other Identifiers 1

Medicaid1444740LA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

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

NATCHEZ HBP SERVICES LLC
Clinic/Center (Radiology)
107 FRONT ST STE 1200
VIDALIA, LA 71373
Concordia Parish (318) 336-2220

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 Clinic LLC's NPI number?

The NPI number for Vicksburg Clinic LLC is 1629279054. It was assigned to this organization in the NPPES registry on May 31, 2007.

Where is Vicksburg Clinic LLC located?

Vicksburg Clinic LLC is located at 107 Front St Ste 1200, Vidalia, LA 71373. The listed phone number is (318) 336-2220.

What is Vicksburg Clinic LLC's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

When was this NPI record last updated?

The NPPES record for Vicksburg Clinic LLC was last updated on February 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.