VICKSBURG CLINIC LLC
NPI 1790711158
Family Medicine in Vicksburg, MS

Q: What is Vicksburg Clinic LLC's NPI number?

The NPI number for Vicksburg Clinic LLC is 1790711158. It was assigned to this organization in the NPPES registry on June 25, 2006.

Q: What is Vicksburg Clinic LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since June 25, 2006

2100 HIGHWAY 61 N, VICKSBURG, MS 39183(601) 883-5000 Get Directions Write a Review

NPPES record last updated: November 20, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 20, 2024, Mar 30, 2023, Jun 14, 2019 (3 updates tracked since 2019).

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About Vicksburg Clinic Llc NPPES

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

VICKSBURG CLINIC LLC (NPI 1790711158) is a healthcare organization registered as a family medicine in Vicksburg, Mississippi and active in the NPI registry since June 2006. The organization lists Kristina Music, Director Provider Enrollment, as its authorized official.

NPPES Registry Identity

NPI1790711158

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameVICKSBURG CLINIC LLC

Location Address2100 HIGHWAY 61 NVicksburg, MS 39183-8211

Mailing AddressPo Box 689022Franklin, TN 37068-9022

Phone(601) 883-5000

Organization SubpartNo

Authorized OfficialKristina MusicDirector Provider Enrollment · (615) 465-7000

Enumeration DateJune 25, 2006

Last NPPES UpdateNovember 20, 20243 updates tracked since enumeration

NPPES CertifiedNovember 20, 2024

✔ NPI 1790711158 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

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.

Also ListedRadiology · Radiation OncologyTaxonomy 2085R0001X

Also ListedGeneral PracticeTaxonomy 208D00000X

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X

2100 HIGHWAY 61 N, Vicksburg, MS 39183

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Other Identifiers 3

Medicaid200002582MS

Medicaid1444596LA

Medicaid1446084LA

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

Other Providers at the Same Location NPPES 20

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

MR. MICHAEL J MCREYNOLDS CRNA

Nurse Anesthetist, Certified Registered