| Upa Pllc Neurology | |
|
2500 N State St Jackson MS 39216-4500 | |
| (601) 984-5275 | |
| Not Available |
| Full Name | Upa Pllc Neurology |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology |
| Location | 2500 N State St, Jackson, Mississippi |
| Authorized Official Name and Position | Owen B Evans (MANAGER) |
| Authorized Official Contact | 6019845214 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Upa Pllc Neurology 2500 N State St Jackson MS 39216-4500 Ph: (601) 984-5275 | Upa Pllc Neurology 2500 N State St Jackson MS 39216-4500 Ph: (601) 984-5275 |
| NPI Number | 1609929470 |
|---|---|
| Provider Enumeration Date | 01/18/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609929470 | NPI | - | NPPES |
| 09014123 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0402X | Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology | (* (Not Available)) | Primary |
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