Upa Pllc Adolescent Med
Pediatric Adolescent Medicine
Upa Pllc Adolescent Med is a Jackson, Mississippi based Pediatric center with medical specialization in
Pediatric Adolescent Medicine.
It is located at
2500 N State St, Jackson, Mississippi - 39216-4500. They can be contacted on phone at
601-984-5236.
NPI number (Unique professional ID) for Upa Pllc Adolescent Med is
1205953809 which was assigned by NPPES on 26 Mar, 2007 and it was last updated on 24 Jun, 2008.
Upa Pllc Adolescent Med specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Upa Pllc Adolescent Med basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Upa Pllc Adolescent Med |
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Business Address:
Upa Pllc Adolescent Med address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 2500 N State St
Jackson, MS, 39216-4500
United States |
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| Phone Number : | 601-984-5236 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1205953809 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 26 Mar, 2007 |
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| Last Updated On : | 24 Jun, 2008 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Owenb Evans |
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| Authorized Official Credential : | M.D. |
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| Official Title or Position : | MANAGING EMPLOYEE |
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| Phone Number : | 601-984-5214 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Upa Pllc Adolescent Med are as mentioned. Primary taxonomy code for Upa Pllc Adolescent Med is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | | |
Legacy Identifiers:
Other legacy medical identifiers of Upa Pllc Adolescent Med such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 09015331 | MEDICAID | MS | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 2500 N State St
Jackson, MS, 39216-4500
United States |
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| Phone Number : | 601-984-5236 |
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Business Location:
Patients can refer following map for directions to
Upa Pllc Adolescent Med practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.