VICKSBURG NEPHROLOGY LLC NPI 1013337658

NPI Information

  • NPI: 1013337658
  • Provider Name: VICKSBURG NEPHROLOGY LLC
  • Classification: Internal Medicine - 207RN0300X
  • Specialization: Nephrology
  • Entity Type: Organization
  • Address: 104 MCAULEY DR
    VICKSBURG, MS
    ZIP 39183
  • Phone: (601) 738-5549

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NPI Details

VICKSBURG NEPHROLOGY LLC is a nephrology internal medicine in Vicksburg, MS. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. VICKSBURG NEPHROLOGY LLC NPI is 1013337658. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

104 MCAULEY DR
VICKSBURG, MS
ZIP 39183-825
Phone: (601) 738-5549
Fax: (601) 630-9120

The provider's authorized official is Michael L Davis .
The authorized official title is Owner and has the following contact phone number (601) 738-5549.

The enumeration date for this NPI number is 4/22/2014 and was last updated on 4/22/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RN0300XInternal MedicineNephrologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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