Vicksburg Clinic LLC
NPI 1629279054ActiveOrganization· Surgery· Vidalia, LA
Surgery in Vidalia, Louisiana, registered in NPPES in May 2007. The authorized official on file is Kristy Music, Director Provider Enrollment. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1629279054 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 31, 2007 |
| Last updated in NPPES | Feb 14, 2025 |
| Certified by provider | Feb 14, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery Primary | 208600000X | — | — |
| Family Medicine | 207Q00000X | — | — |
| Internal Medicine | 207R00000X | — | — |
| Obstetrics & Gynecology | 207V00000X | — | — |
| Urology | 208800000X | — | — |
| General Practice | 208D00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (LA) |
|---|
Other general surgeons in Vidalia
- 1851113567