E Joseph Upton, Md Pa | |
107 Bryan St Dayton TX 77535-2661 | |
(936) 258-4600 | |
(936) 258-4603 |
Full Name | E Joseph Upton, Md Pa |
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Speciality | Pediatrics |
Location | 107 Bryan St, Dayton, Texas |
Authorized Official Name and Position | E Joseph Upton (OWNER) |
Authorized Official Contact | 9362584600 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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E Joseph Upton, Md Pa Po Box 65 Dayton TX 77535-0002 Ph: (936) 258-4600 | E Joseph Upton, Md Pa 107 Bryan St Dayton TX 77535-2661 Ph: (936) 258-4600 |
NPI Number | 1306027016 |
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Provider Enumeration Date | 11/21/2007 |
Last Update Date | 11/21/2007 |
Medicare PECOS PAC ID | 7911944574 |
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Medicare Enrollment ID | O20050414000738 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306027016 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | H2859 (Texas) | Secondary |
208000000X | Pediatrics | H2859 (Texas) | Primary |
Provider Name | Edwin Joseph Upton |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1932130440 PECOS PAC ID: 3375508492 Enrollment ID: I20041130000735 |
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