Vicksburg Clinic Llc in Vidalia, LA

Vicksburg Clinic Llc is a medicare enrolled primary clinic (Surgery) in Vidalia, Louisiana. The current practice location for Vicksburg Clinic Llc is 107 Front St Ste 1200, Vidalia, Louisiana. For appointments, you can reach them via phone at (318) 336-2220. The mailing address for Vicksburg Clinic Llc is 508 Broadway, Delhi, Louisiana and phone number is (318) 878-3737.

Vicksburg Clinic Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1629279054. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (318) 336-2220.

Contact Information

	Vicksburg Clinic Llc
	107 Front St Ste 1200 Vidalia LA 71373-2834
	(318) 336-2220
	(318) 336-6060

Map and Direction

Primary Care Clinic Profile

Full Name	Vicksburg Clinic Llc
Speciality	Surgery
Location	107 Front St Ste 1200, Vidalia, Louisiana
Authorized Official Name and Position	Kristy Music (DIRECTOR PROVIDER ENROLLMENT)
Authorized Official Contact	6154657377
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Vicksburg Clinic Llc 508 Broadway Delhi LA 71232-3002 Ph: (318) 878-3737	Vicksburg Clinic Llc 107 Front St Ste 1200 Vidalia LA 71373-2834 Ph: (318) 336-2220

NPI Details:

NPI Number	1629279054
Provider Enumeration Date	05/31/2007
Last Update Date	02/14/2025

Medicare PECOS Information:

Medicare PECOS PAC ID	5890696330
Medicare Enrollment ID	O20050322000036

Medical Identifiers

Medical identifiers for Vicksburg Clinic Llc such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1629279054	NPI	-	NPPES
1444740	Medicaid	LA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	(* (Not Available))	Secondary
207R00000X	Internal Medicine	(* (Not Available))	Secondary
207V00000X	Obstetrics & Gynecology	(* (Not Available))	Secondary
208800000X	Urology	(* (Not Available))	Secondary
208D00000X	General Practice	(* (Not Available))	Secondary
208600000X	Surgery	(* (Not Available))	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Vicksburg Clinic Llc acts as a billing entity for following providers:

Provider Name	William Porter
Provider Type	Practitioner - Orthopedic Surgery
Provider Identifiers	NPI Number: 1528099413 PECOS PAC ID: 5698838423 Enrollment ID: I20240814004791

Reviews and Comments

Surgery in Vidalia, LA

Tensas Community Health Center Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 900 Carter St Ste A, Vidalia, LA 71373 Phone: 318-766-1967
Seki Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1812 Carter St, Vidalia, LA 71373 Phone: 318-336-7072
Just Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4001 Carter St Rm 7, Vidalia, LA 71373 Phone: 318-336-5231
Riverpark Primary Health Clinic, Llc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 Front Street, Vidalia, LA 71373 Phone: 318-336-2218 Fax: 318-336-6066
Pediatric & Adolescent Clinic Of Louisiana Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1806 Carter St, Vidalia, LA 71373 Phone: 318-336-7172 Fax: 318-336-7176
David Alan Timm Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1806 Carter Street, Vidalia, LA 71373 Phone: 318-336-7172 Fax: 318-336-7172

Vicksburg Clinic Llc - Medicare Primary Care in Vidalia, LA