VICKSBURG ONCOLOGY ASSOCIATES LLC (NPI# 1174613830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174613830 |
| Entity Type | Organization |
| Organization Name | VICKSBURG ONCOLOGY ASSOCIATES LLC |
| Practice Address |
970 Lakeland Dr Ste 34 Jackson MS 39216-4640 |
| Mailing Address |
Po Box 4997 Jackson MS 39296-4997 |
| Practice Telephone | 6013620600 |
| Practice Fax Number | 6016383227 |
| Mailing Telephone | 6013620600 |
| Mailing Fax Number | 6016383227 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2019-01-11 |
| Authorized Official Name | STEVEN ZACHOW (PRESIDENT) |
| Authorized Official Telephone | 6016383005 |
| Authorized Official Credential | MC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1944653 | 05 | |
| MS | BLUE CROSS ACH | 91-066632 | 01 |
| LA | 1961817 | 05 | |
| LA | 1961825 | 05 | |
| MS | 09014095 | 05 |
| Street Address |
970 LAKELAND DR STE 34 |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-4640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841224433 | Regents of The University of Michigan | Radiology | 1102 East Michigan Ave, Jackson, MI 49201-0010 | 2006-07-10 |
| 1023072485 | Paul D Koerner | Radiology | 322 Hosp Blvd, Cancer Care Center of Jackson, Jackson, TN 38305 | 2006-04-13 |
| 1184607210 | Srinivasan Vijayakumar | Radiology | 350 W Woodrow Wilson Ave, Suite 16, Jackson, MS 39213-7681 | 2005-11-22 |
| 1013919216 | Richard B Friedman | Radiology | 1225 N State St, Jackson, MS 39202-2064 | 2005-06-01 |
| 1518969724 | Steven E Zachow | Radiology | 1850 Chadwick Dr, Jackson, MS 39204-3404 | 2005-06-01 |
| 1497757603 | Sidney A Johnson Jr. | Radiology | 2969 Curran Dr N, Jackson, MS 39216-4121 | 2005-06-01 |
| 1144883620 | W A Foote Memorial Hospital Inc | Radiology | 205 N East Ave, Jackson, MI 49201-1753 | 2019-04-19 |
| 1124584800 | Teessa Perekattu Kuruvilla | Radiology | Department of Radiation Oncology, 350 Woodrow Wilson Dr, Jackson, MS 39216-4505 | 2019-02-18 |
| 1194245472 | W. A. Foote Memorial Hospital, Inc | Radiology | 205 N East Ave, Jackson, MI 49201-1753 | 2017-06-27 |
| 1043743339 | Hiba Ahmed | Radiology | 350 W Woodrow Wilson Ave Ste 1600, Jackson, MS 39213-7627 | 2017-04-04 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.