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General NPI Number Information
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NPI Number | 1952288029
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Entity Type | Organization
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Legal Business Name | UPTIV HEALTH MI PC
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Dates
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Enumeration Date | 08/19/2025
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 7330 HIGHLAND RD STE B4
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City | BATON ROUGE
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State | LA
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Zip | 70808-6643
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Country | US
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Telephone | 734-203-0176
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Fax | 888-373-5528
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Provider Business Mailing Address
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Address Line | 5543 EDMONDSON PIKE STE 162
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City | NASHVILLE
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State | TN
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Zip | 37211-5808
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Country | US
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Telephone | 734-203-0176
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Fax | 888-373-5528
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Authorized Official
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Title or Position | SR. OPS DIRECTOR
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Name | FRANKIE ALLEN DEJESUS
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Credential |
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Telephone | 615-430-7119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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