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

Vicksburg Spine Center, LLC

Organization Ambulatory Surgical Clinic/Center · NPI 1134896038

Vicksburg Spine Center, LLC is an Ambulatory Surgical Clinic/Center in Vicksburg, Mississippi. Registered with an NPI since 2021.

In the registry since
2021
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

1903C Mission 66
Vicksburg, MS 39180-3711
Phone: (601) 883-6304
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ambulatory Surgical Clinic/Center (primary) Taxonomy 261QA1903X

Record details

NPI number1134896038
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shannon Hylton — Manager · (816) 547-5498
NPI enumeratedAugust 27, 2021
Last updated in NPPESAugust 22, 2024
Certification dateAugust 22, 2024
Mailing address11417 Ne State Route 33, Liberty, MO 64068-7306

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