Upa Pllc North Clinic

NPI 1649397373 - Pediatrics - 208000000X

NPI Details
NPI 1649397373
Enumeration Date 03/26/2007
Last Updated 07/09/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name OWEN B OWEN
Position MANAGING EMPLOYEE
Phone (601) 815-5300
Fax
Practice Location
5965 I 55 N
JACKSON MS, 39213-9722, US
Phone (601) 815-5300
Fax
Business Location
2500 N STATE ST
JACKSON MS, 39216-4500, US
Phone (601) 984-2198
Fax
Toxanomy
Taxonomy Code 208000000X
License State
License Number
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According to our database, Upa Pllc North Clinic NPI is 1649397373, taxonomy code is 208000000X Upa Pllc North Clinic physically located at 5965 I 55 N, Jackson MS, 39213-9722. NPI Number 1033115704 has the healthcare provider type.

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1649397373 NPI number is provided on an as is basis without warranty of any kind. 1649397373 is maintained by the National Plan & Provider Enumeration System. The contents of Upa Pllc North Clinic are for informational purposes only.