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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

NPI # 1174613830
LBN Legal business name VICKSBURG ONCOLOGY ASSOCIATES LLC
Authorized official STEVEN ZACHOW - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 10/13/2006
Last updated 01/11/2019 - About 7 years ago
Identifiers
LA Medicaid 1944653
LA Medicaid 1961817
LA Medicaid 1961825
MS Medicaid 09014095
MS Other 91-066632 BLUE CROSS ACH
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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