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

Vicksburg Clinic LLC

Organization Allergy Physician · NPI 1659307791

Vicksburg Clinic LLC is an Allergy Physician in Vicksburg, Mississippi. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
13
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1115 N Frontage Rd
Vicksburg, MS 39180-5102
Phone: (601) 634-8790
Show map & directions

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

Specialties & licences

Infectious Disease Physician (primary) Taxonomy 207RI0200X
Allergy Physician Taxonomy 207KA0200X
Family Medicine Physician Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X
Cardiovascular Disease Physician Taxonomy 207RC0000X
Pulmonary Disease Physician Taxonomy 207RP1001X
Obstetrics Physician Taxonomy 207VX0000X
Orthopaedic Surgery Physician Taxonomy 207X00000X
Pediatrics Physician Taxonomy 208000000X
Neurology Physician Taxonomy 2084N0400X
Surgery Physician Taxonomy 208600000X
Urology Physician Taxonomy 208800000X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1659307791
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Debbie Brewer — Director Of Provider Enrollment · (877) 892-9813
NPI enumeratedJune 23, 2006
Last updated in NPPESNovember 25, 2008
Mailing address1115 N Frontage Rd, Vicksburg, MS 39180-5102