Upa Pllc Ambulatory

LBN: Upa Pllc Ambulatory
Upa Pllc Ambulatory is an health care organization with primary practice located at 2500 N State St , Jackson MS 39216-4500. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Upa Pllc Ambulatory can be contacted via phone (601) 984-2195, or through Evans, Owen B via phone (601) 984-5214.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (601) 984-2195
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Evans, Owen B Doctor of Medicine (MD)
Phone: (601) 984-5214

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X

Profile Details

NPI number 1528185121
LBN Legal business name Upa Pllc Ambulatory
DBA Doing business as
Authorized official Evans, Owen B Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 26th, 2007
Last updated Jun 19th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528185121 NPPES
Mississippi MEDICAID 09014116

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