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

Vicksburg Special Care Clinic LLC

Organization Family Medicine Physician · NPI 1487988002

Vicksburg Special Care Clinic LLC is a Family Medicine Physician in Vicksburg, Mississippi. Registered with an NPI since 2009.

In the registry since
2009
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

4077 Pemberton Square Blvd
Vicksburg, MS 39180-5580
Phone: (601) 638-8600
Fax: (601) 638-8661
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1487988002
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mitchell Barrett — Owner/Member · (601) 529-9341
NPI enumeratedSeptember 29, 2009
Last updated in NPPESOctober 29, 2014
Mailing address4077 Pemberton Square Blvd, Vicksburg, MS 39180-5580

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