Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tupelo Plastic Surgery Clinic of Tupelo PA

Organization Plastic Surgery Physician · NPI 1649381104

Tupelo Plastic Surgery Clinic of Tupelo PA is a Plastic Surgery Physician in Tupelo, Mississippi. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4381 S Eason Blvd Ste 101 Longtown Medical Park
Tupelo, MS 38801-6586
Phone: (662) 377-6630
Fax: (662) 377-6635
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X

Record details

NPI number1649381104
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Robert Buckley — Md · (662) 377-6630
NPI enumeratedAugust 31, 2006
Last updated in NPPESFebruary 29, 2008
Mailing address450 E President Ave, Tupelo, MS 38801-5599

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