Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Vicksburg Clinic LLC

Infectious Disease Physician in Vicksburg, MS · enumerated 2006 · authorized official Debbie Brewer, Director of Provider Enrollment.

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

National Provider Identifier

1659307791

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Registry record

Entity type Organization (Type 2)

Legal business name Vicksburg Clinic LLC

Practice address 1115 N Frontage Rd, Vicksburg, MS, 39180

Phone (601) 634-8790

Enumeration date Jun 23, 2006

Last updated in NPPES Nov 25, 2008

Taxonomy & classification

207KA0200X Allergy Physician Allopathic & Osteopathic Physicians Secondary

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians Secondary

207R00000X Internal Medicine Physician Allopathic & Osteopathic Physicians Secondary

207RC0000X Cardiovascular Disease Physician Allopathic & Osteopathic Physicians Secondary

207RI0200X Infectious Disease Physician Allopathic & Osteopathic Physicians Primary

207RP1001X Pulmonary Disease Physician Allopathic & Osteopathic Physicians Secondary

207VX0000X Obstetrics Physician Allopathic & Osteopathic Physicians Secondary

207X00000X Orthopaedic Surgery Physician Allopathic & Osteopathic Physicians Secondary

208000000X Pediatrics Physician Allopathic & Osteopathic Physicians Secondary

2084N0400X Neurology Physician Allopathic & Osteopathic Physicians Secondary

208600000X Surgery Physician Allopathic & Osteopathic Physicians Secondary

208800000X Urology Physician Allopathic & Osteopathic Physicians Secondary

363L00000X Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Secondary

Authorized official

Name Debbie Brewer

Title Director of Provider Enrollment

Phone (877) 892-9813

Other identifiers

Identifier	Type	State	Issuer
09015545	Medicaid	MS	-
09015549	Medicaid	MS	-
09015546	Medicaid	MS	-
09015547	Medicaid	MS	-
1111716	Medicaid	LA	-
00720204	Medicaid	MS	-

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

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2008-11-25. Verify at npiregistry.cms.hhs.gov.

Where is Vicksburg Clinic LLC located?

The practice location on file with NPPES is in Vicksburg, MS.

Providers at this address

Browse all →

Gordon Sluis Pediatrics Physician · Vicksburg, MS NPI 1831127422 Anita Tribble Internal Medicine Physician · Vicksburg, MS NPI 1801824495 Thomas Moore Pediatrics Physician · Vicksburg, MS NPI 1184655060 Philip Scurria Psychiatry Physician · Vicksburg, MS NPI 1861423766 Rebecca Tustain Nurse Practitioner · Vicksburg, MS NPI 1992730998 Vicksburg Clinic LLC Durable Medical Equipment & Medical Supplies · Vicksburg, MS NPI 1154532257

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2008-11-25.