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 1790711158

Vicksburg Clinic LLC is a Family Medicine Physician in Vicksburg, Mississippi. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
4
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

2100 Highway 61 N
Vicksburg, MS 39183-8211
Phone: (601) 883-5000
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Radiation Oncology Physician Taxonomy 2085R0001X
General Practice Physician Taxonomy 208D00000X
Family Nurse Practitioner Taxonomy 363LF0000X

Record details

NPI number1790711158
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kristina Music — Director Provider Enrollment · (615) 465-7000
NPI enumeratedJune 25, 2006
Last updated in NPPESNovember 20, 2024
Certification dateNovember 20, 2024
Mailing addressPo Box 689022, Franklin, TN 37068-9022

Other providers in Vicksburg