Healthcare Provider Details

I. General information

NPI: 1972186849
Provider Name (Legal Business Name): ARIEL MIRANDA UPTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ARIEL MIRANDA CHILDS

II. Dates (important events)

Enumeration Date: 04/29/2021
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 INDEPENDENCE BLDG 1100
COLUMBUS MS
39710-5300
US

IV. Provider business mailing address

201 INDEPENDENCE
COLUMBUS MS
39710-5300
US

V. Phone/Fax

Practice location:
  • Phone: 662-434-2273
  • Fax:
Mailing address:
  • Phone: 662-434-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number36911
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number36911
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: