Vicksburg Clinic Llc is a medicare enrolled primary clinic (Family Medicine) in Delhi, Louisiana. The current practice location for Vicksburg Clinic Llc is 508 Broadway, Delhi, Louisiana. For appointments, you can reach them via phone at
(318) 878-3737. 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) 878-3737.
Primary Care Clinic Profile
Full Name | Vicksburg Clinic Llc |
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Speciality | Family Medicine |
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Location | 508 Broadway, Delhi, Louisiana |
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Authorized Official Name and Position | Debbie T Brewer (DIRECTOR OF PROVIDER ENRILLMENT) |
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Authorized Official Contact | 8778929813 |
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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 508 Broadway Delhi LA 71232-3002 Ph: (318) 878-3737 |
NPI Details:
NPI Number | 1629279054 |
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Provider Enumeration Date | 05/31/2007 |
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Last Update Date | 06/09/2008 |
Medicare PECOS Information:
Medicare PECOS PAC ID | 5890696330 |
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Medicare Enrollment ID | O20050322000036 |
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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)) | Primary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
207V00000X | Obstetrics & Gynecology | (* (Not Available)) | Secondary |
208600000X | Surgery | (* (Not Available)) | Secondary |
208800000X | Urology | (* (Not Available)) | Secondary |
208D00000X | General Practice | (* (Not Available)) | Secondary |
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 |
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Provider Type | Practitioner - Orthopedic Surgery |
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Provider Identifiers | NPI Number: 1528099413 PECOS PAC ID: 5698838423 Enrollment ID: I20240814004791 |
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