Healthcare Provider Details

I. General information

NPI: 1558927905
Provider Name (Legal Business Name): UPPAL MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2019
Last Update Date: 09/02/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1727 E UNION ST
GREENVILLE MS
38703-3253
US

IV. Provider business mailing address

215 KATHERINE DR STE A
FLOWOOD MS
39232-9588
US

V. Phone/Fax

Practice location:
  • Phone: 662-577-6673
  • Fax:
Mailing address:
  • Phone: 601-665-4162
  • Fax: 855-830-3484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER J WATKINS
Title or Position: CEO
Credential:
Phone: 601-665-4162