VICKSBURG CLINIC LLC NPI 1659307791

NPI Information

  • NPI: 1659307791
  • Provider Name: VICKSBURG CLINIC LLC
  • Classification: Internal Medicine - 207RI0200X
  • Specialization: Infectious Disease
  • Entity Type: Organization
  • Address: 1115 N FRONTAGE RD
    VICKSBURG, MS
    ZIP 39180
  • Phone: (601) 634-8790

Map and Directions

Get Directions

NPI Details

VICKSBURG CLINIC LLC is an infectious disease internal medicine in Vicksburg, MS. The provider is an internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. VICKSBURG CLINIC LLC NPI is 1659307791. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1115 N FRONTAGE RD
VICKSBURG, MS
ZIP 39180-102
Phone: (601) 634-8790

The provider's authorized official is Debbie T Brewer .
The authorized official title is Director Of Provider Enrollment and has the following contact phone number (877) 892-9813.

The enumeration date for this NPI number is 6/23/2006 and was last updated on 11/25/2008.

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
1208600000XSurgeryNo
2207RP1001XInternal MedicinePulmonary DiseaseNo
3207VX0000XObstetrics & GynecologyObstetricsNo
4207Q00000XFamily MedicineNo
5207R00000XInternal MedicineNo
6207KA0200XAllergy & ImmunologyAllergyNo
7207RC0000XInternal MedicineCardiovascular DiseaseNo
8208000000XPediatricsNo
9207X00000XOrthopaedic SurgeryNo
102084N0400XPsychiatry & NeurologyNeurologyNo
11363L00000XNurse PractitionerNo
12208800000XUrologyNo
13207RI0200XInternal MedicineInfectious DiseaseYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
109015545MEDICAIDMISSISSIPPI
200720204MEDICAIDMISSISSIPPI
309015547MEDICAIDMISSISSIPPI
4C02561MEDICARE PINMISSISSIPPI
5CH4242MEDICARE PINMISSISSIPPI
61111716MEDICAIDLOUISIANA
709015549MEDICAIDMISSISSIPPI
809015546MEDICAIDMISSISSIPPI

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

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI