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Vicksburg Clinic LLC

Surgery Physician in Vidalia, LA · enumerated 2007 · authorized official Kristy Music, Director Provider Enrollment.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1629279054

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Registry record

Entity type Organization (Type 2)
Legal business name Vicksburg Clinic LLC
Practice address 107 Front St Ste 1200, Vidalia, LA, 71373
Phone (318) 336-2220
Fax (318) 336-6060
Enumeration date May 31, 2007
Last updated in NPPES Feb 14, 2025

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians Secondary
207R00000X Internal Medicine Physician Allopathic & Osteopathic Physicians Secondary
207V00000X Obstetrics & Gynecology Physician Allopathic & Osteopathic Physicians Secondary
208600000X Surgery Physician Allopathic & Osteopathic Physicians Primary
208800000X Urology Physician Allopathic & Osteopathic Physicians Secondary
208D00000X General Practice Physician Allopathic & Osteopathic Physicians Secondary

Authorized official

Name Kristy Music
Title Director Provider Enrollment
Phone (615) 465-7377

Other identifiers

Identifier Type State Issuer
1444740 Medicaid LA -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Vicksburg Clinic LLC?
The NPI for Vicksburg Clinic LLC is 1629279054, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Vicksburg Clinic LLC?
NPPES lists Kristy Music (Director Provider Enrollment) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-02-14.