VICKSBURG CLINIC LLC
VICKSBURG CLINIC LLC is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1629279054, based in Vidalia, LA. The organization lists 6 taxonomy classifications, with Surgery Physician recorded as primary.
Getting there
The practice address on file is 107 FRONT ST STE 1200, Vidalia, LA 71373. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
NPPES does not list a state licence number for this record. That is not unusual — organizations and some provider types are not required to file one. Verify current licensure with the relevant state board before care.
- Status
- Approved
- Provider type
- Part B Supplier - Clinic/group Practice
- PAC ID
- 5890696330
- Enrollment ID
- O20050322000036
Medicare enrolment is recorded as approved under the provider type Part B Supplier - Clinic/group Practice. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Surgery covers
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. NUCC Health Care Provider Taxonomy, code 208600000X
All registered taxonomy codes
This provider registers 6 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 207Q00000X | Family Medicine Physician | — | — | |
| 207R00000X | Internal Medicine Physician | — | — | |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | |
| 208600000X | Surgery Physician | — | — | primary |
| 208800000X | Urology Physician | — | — | |
| 208D00000X | General Practice Physician | — | — |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1629279054 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | May 31, 2007 |
| Last updated | Feb 14, 2025 |
| Status | Active |
| Practice address |
107 FRONT ST STE 1200 Vidalia, LA 71373 (318) 336-2220 Fax (318) 336-6060 |
| Mailing address |
508 BROADWAY Delhi, LA 71232 |
| Other identifiers |
1444740
· Medicaid (LA) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 6 | 2 | 9 | 2 | 7 | 9 | 0 | 5 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 6 | 4 | 9 | 4 | 7 | 9 | 0 | 1 |
Sum = 66 · next multiple of 10 = 70 · check digit = 4 · actual last digit = 4
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.