Vicksburg Medical Teams Mht LLC
NPI #1023419801 in Vicksburg, Mississippi
Provider Information
- NPI Number
- 1023419801
- Entity Type
- Organization
- Organization Name
- Vicksburg Medical Teams Mht LLC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Sep 11, 2014
- Last Updated
- Jan 2, 2015
Practice Location
- Address
- 2080 S FRONTAGE RD
- Address 2
- SUITE 100
- City
- Vicksburg
- State
- Mississippi
- ZIP Code
- 39180-5328
- Phone
- (601) 529-5466
Authorized Official
- Name
- SAM PIERCE, MD
- Title
- OWNER/PRESIDENT
- Phone
- (601) 262-1000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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