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UPA PLLC NEPHROLOGY NPI 1790838563


NPI Information

NPI: 1790838563
Provider Name: UPA PLLC NEPHROLOGY
Classification: Pediatrics - 2080P0210X
Entity Type: Organization

Specialization: Pediatric Nephrology

Address:
2500 N STATE ST
JACKSON, MS
ZIP 39216
Phone: (601) 815-8985
Get Directions

UPA PLLC NEPHROLOGY is a pediatric nephrology pediatrics in Jackson, MS. The provider is a pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy. UPA PLLC NEPHROLOGY NPI is 1790838563. 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) 815-8985

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
12080P0210XPediatricsPediatric NephrologyYes

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
109014114MEDICAIDMISSISSIPPI

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

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