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UPA PLLC HEMATOLOGY NPI 1083767842


NPI Information

NPI: 1083767842
Provider Name: UPA PLLC HEMATOLOGY
Classification: Pediatrics - 2080P0207X
Entity Type: Organization

Specialization: Pediatric Hematology-Oncology

Address:
2500 N STATE ST
JACKSON, MS
ZIP 39216
Phone: (601) 815-4249
Get Directions

UPA PLLC HEMATOLOGY is a pediatric hematology-oncology pediatrics in Jackson, MS. The provider is a pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. UPA PLLC HEMATOLOGY NPI is 1083767842. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2500 N STATE ST
JACKSON, MS
ZIP 39216-500
Phone: (601) 815-4249

The provider's authorized official is Owen B Evans .
The authorized official title is Manager and has the following contact phone number (601) 984-5214.

The enumeration date for this NPI number is 1/18/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12080P0207XPediatricsPediatric Hematology-OncologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
109014122MEDICAIDMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.