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

Vicksburg Clinic LLC

Organization Family Medicine Physician · NPI 1629279054

Vicksburg Clinic LLC is a Family Medicine Physician in Vidalia, Louisiana. Registered with an NPI since 2007.

In the registry since
2007
Specialties on file
6
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

107 Frnt ST Ste 1200
Vidalia, LA 71373-2834
Phone: (318) 336-2220
Fax: (318) 336-6060
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X
Family Medicine Physician Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X
Obstetrics & Gynecology Physician Taxonomy 207V00000X
Urology Physician Taxonomy 208800000X
General Practice Physician Taxonomy 208D00000X

Record details

NPI number1629279054
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kristy Music — Director Provider Enrollment · (615) 465-7377
NPI enumeratedMay 31, 2007
Last updated in NPPESFebruary 14, 2025
Certification dateFebruary 14, 2025
Mailing address508 Broadway, Delhi, LA 71232-3002

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