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

Upa PLLC Adolescent Med

Organization Pediatric Adolescent Medicine Physician · NPI 1205953809

Upa PLLC Adolescent Med is a Pediatric Adolescent Medicine Physician in Jackson, Mississippi. Registered with an NPI since 2007.

In the registry since
2007
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2500 N State St
Jackson, MS 39216-4500
Phone: (601) 984-5236
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Adolescent Medicine Physician (primary) Taxonomy 2080A0000X

Record details

NPI number1205953809
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Owen Evans — Managing Employee · (601) 984-5214
NPI enumeratedMarch 26, 2007
Last updated in NPPESJune 24, 2008
Mailing address2500 N State St, Jackson, MS 39216-4500

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