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Organization
VICKSBURG HEALTHCARE LLC
Active
Organization
VICKSBURG HEALTHCARE LLC
Active
Parent organization
VICKSBURG HEALTHCARE LLC
Other names
River Region Health System
Organization subpart
Yes
Provider details
NPI number
Legal business name
VICKSBURG HEALTHCARE LLC
Authorized official
KRISTY MUSIC (DIRECTOR PROVIDER ENROLLMENT)
(615) 465-7000
Entity
Organization
Contact information
Practice address
2100 HIGHWAY 61 N, VICKSBURG, MS 39183-8211
(601) 883-5695
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-3000
(615) 628-6877
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
NULL
207L00000X
Anesthesiology Physician
Primary
—
—
207P00000X
Emergency Medicine Physician
—
NULL
207P00000X
Emergency Medicine Physician
—
—
207ZC0500X
Cytopathology Physician
—
NULL
207ZC0500X
Cytopathology Physician
—
—
207ZP0101X
Anatomic Pathology Physician
—
NULL
207ZP0101X
Anatomic Pathology Physician
—
—
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
—
NULL
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
NULL
367500000X
Certified Registered Nurse Anesthetist
—
—
367H00000X
Anesthesiologist Assistant
—
NULL
367H00000X
Anesthesiologist Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000583271
—
MS
05
—
1444600
—
LA
05
—
200008380
—
MS
05
—
200008980
—
MS
05
—
200009033
—
MS
05
—
200010284
—
MS
Enumeration date
07/31/2006
Last updated
09/02/2025
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