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Organization
VICKSBURG MEDICAL TEAMS MHT LLC
Active
Organization
VICKSBURG MEDICAL TEAMS MHT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAM PIERCE MD (OWNER/PRESIDENT)
(601) 262-1000
Entity
Organization
Contact information
Practice address
2080 S FRONTAGE RD, SUITE 100, VICKSBURG, MS 39180-5328
(601) 529-5466
Mailing address
1515 HERITAGE DRIVE, SUITE 110, MCKINNEY, TX 75069-3379
(817) 470-7377
(877) 343-3192
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/11/2014
Last updated
01/02/2015
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