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UNIVERSITY PEDIATRIC ASSOCIATES, PLLC

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Company Details

Name: UNIVERSITY PEDIATRIC ASSOCIATES, PLLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Dissolved
Effective Date: 05 Jul 1995 (30 years ago)
Business ID: 619848
State of Incorporation: MISSISSIPPI

Agent

Name Role Address
OWEN B. EVANS, M.D. Agent 2500 NORTH STATE STREET, JACKSON, MS 39216

Member

Name Role Address
OWEN B EVANS Member 2500 N STATE ST, JACKSON, MS 39216
HOLMES S ADAMS Member 248 E CAPITOL ST #1400, JACKSON, MS 39201

National Provider Identifier

NPI Number:
1396853149

Authorized Person:

Name:
DR. OWEN B EVANS
Role:
MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
208000000X - Pediatrics Physician
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
640860622
Plan Year:
2009
Number Of Participants:
139
Sponsors Telephone Number:

Filings

Type Status Filed Date Description
Failure to File AR Filed 2011-12-05 Failure to File AR
See File Filed 2002-01-29 See File
Name Reservation Form Filed 1995-07-05 Name Reservation

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Date of last update: 19 Jun 2025

Sources: Company Profile on Mississippi Secretary of State Website