Upa Pllc Child Dev Clinic

LBN: Upa Pllc Child Dev Clinic
Upa Pllc Child Dev Clinic 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 / Developmental – Behavioral Pediatrics, which is considered as the primary health care specialty. Upa Pllc Child Dev Clinic can be contacted via phone (601) 984-5274, 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) 984-5274
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 / Developmental – Behavioral Pediatrics 2080P0006X

Profile Details

NPI number 1841343605
LBN Legal business name Upa Pllc Child Dev Clinic
DBA Doing business as
Authorized official Evans, Owen B Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 18th, 2007
Last updated Jun 24th, 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 1841343605 NPPES
Mississippi MEDICAID 09014110

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