Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Central Mississippi Medical Clinic PLLC

Organization Internal Medicine Physician · NPI 1316813868

Central Mississippi Medical Clinic PLLC is an Internal Medicine Physician in Vicksburg, Mississippi. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2200 Highway 61 N Ste 2100
Vicksburg, MS 39183-8246
Phone: (601) 955-3223
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X

Record details

NPI number1316813868
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joseph Blackston — Owner · (601) 955-3223
NPI enumeratedOctober 13, 2025
Last updated in NPPESOctober 13, 2025
Certification dateOctober 13, 2025
Mailing address1900 Petit Bois St N, Jackson, MS 39211-6707

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