Upa Pllc Jackson Med Mall
Pediatrics
Upa Pllc Jackson Med Mall is a Jackson, Mississippi based Pediatric center with medical specialization in
General Pediatrics.
It is located at
2500 N State St, Jackson, Mississippi - 39216-4500. They can be contacted on phone at
601-984-2198.
NPI number (Unique professional ID) for Upa Pllc Jackson Med Mall is
1386797991 which was assigned by NPPES on 18 Jan, 2007 and it was last updated on 22 Aug, 2020.
Upa Pllc Jackson Med Mall is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Upa Pllc Jackson Med Mall basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Upa Pllc Jackson Med Mall |
|---|
Business Address:
Upa Pllc Jackson Med Mall 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 |
|---|
| Phone Number : | 601-984-2198 |
|---|
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 : | 1386797991 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 18 Jan, 2007 |
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| Last Updated On : | 22 Aug, 2020 |
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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 : | MANAGER |
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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 Jackson Med Mall are as mentioned. Primary taxonomy code for Upa Pllc Jackson Med Mall is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | | |
Legacy Identifiers:
Other legacy medical identifiers of Upa Pllc Jackson Med Mall such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 09014542 | 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 : | 601-984-2198 |
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Business Location:
Patients can refer following map for directions to
Upa Pllc Jackson Med Mall 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.