| Vicksburg Medical Teams Mht Llc | |
|
2080 S Frontage Rd Suite 100 Vicksburg MS 39180-5328 | |
| (601) 529-5466 | |
| Not Available |
| Full Name | Vicksburg Medical Teams Mht Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2080 S Frontage Rd, Vicksburg, Mississippi |
| Authorized Official Name and Position | Sam Pierce (OWNER/PRESIDENT) |
| Authorized Official Contact | 6012621000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vicksburg Medical Teams Mht Llc 1515 Heritage Drive Suite 110 Mckinney TX 75069-3379 Ph: (817) 470-7377 | Vicksburg Medical Teams Mht Llc 2080 S Frontage Rd Suite 100 Vicksburg MS 39180-5328 Ph: (601) 529-5466 |
| NPI Number | 1023419801 |
|---|---|
| Provider Enumeration Date | 09/11/2014 |
| Last Update Date | 01/02/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023419801 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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