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Contact Information

VICKSBURG ONCOLOGY ASSOCIATES LLC
970 LAKELAND DR STE 34
JACKSON, MS39216-4640
 Phone: 601-362-0600
 Fax: 601-638-3227
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Radiation Oncology

2085R0001X 92 Physician/Radiation Oncology
Indicates primary specialty

NPI Profile & details for VICKSBURG ONCOLOGY ASSOCIATES LLC · (Female)

NPI Number 1174613830
Status Active
Credentials
Entity Individual
Enumeration date 10/13/2006
Last updated 01/11/2019 - About 7 years ago
Sole proprietor 1 Not specified
Identifiers
  • LA Medicaid 1944653
  • LA Medicaid 1961817
  • LA Medicaid 1961825
  • MS Medicaid 09014095
  • MS Other 91-066632 BLUE CROSS ACH
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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