# UPA PLLC NEPHROLOGY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790838563
- **Authorized official:** DR. OWEN B EVANS M.D. (MANAGER)
- **Authorized official phone:** (601) 984-5214

## Contact information

- **Practice address:** 2500 N STATE ST, JACKSON, MS 39216-4500
- **Practice address phone:** (601) 815-8985
- **Mailing address:** 2500 N STATE ST, JACKSON, MS 39216-4500
- **Mailing address phone:** (601) 815-8985

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080P0210X | Pediatric Nephrology Physician | — | NULL | Yes |
| 2080P0210X | Pediatric Nephrology Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/18/2007
- **Last updated:** 08/22/2020