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Organization

VICKSBURG CLINIC LLC

Active
Parent organization
VICKSBURG CLINIC LLC
Other names
River Region Rural Health - MOB1
Organization subpart
Yes

Provider details

NPI number
Legal business name
VICKSBURG CLINIC LLC
Authorized official
KRISTINA MUSIC (DIRECTOR PROVIDER ENROLLMENT)
(877) 892-9815
Entity
Organization

Contact information

Practice address
2100 HIGHWAY 61 N, VICKSBURG, MS 39183-8211
(601) 883-5000
Mailing address
7100 COMMERCE WAY, SUITE 180, BRENTWOOD, TN 37027-2829
(877) 892-9813
(615) 465-3007

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
MS

Other

Enumeration date
07/17/2009
Last updated
11/05/2024
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