# VICKSBURG HEALTHCARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** VICKSBURG HEALTHCARE LLC
- **Other names:** River Region Health System
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1629084058
- **Legal business name:** VICKSBURG HEALTHCARE LLC
- **Authorized official:** KRISTY MUSIC (DIRECTOR PROVIDER ENROLLMENT)
- **Authorized official phone:** (615) 465-7000

## Contact information

- **Practice address:** 2100 HIGHWAY 61 N, VICKSBURG, MS 39183-8211
- **Practice address phone:** (601) 883-5695
- **Mailing address:** PO BOX 689022, FRANKLIN, TN 37068-9022
- **Mailing address phone:** (615) 465-3000
- **Mailing address fax:** (615) 628-6877

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |
| 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

- **Enumeration date:** 07/31/2006
- **Last updated:** 09/02/2025

## 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 |