Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Tupelo Plastic Surgery Clinic of Tupelo PA

Organization Plastic Surgery Physician · NPI 1649381104

Tupelo Plastic Surgery Clinic of Tupelo PA provides Plastic Surgery Physician services in Tupelo, Mississippi. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4381 S Eason Blvd Ste 101 Longtown Medical Park
Tupelo, MS 38801-6586 Not confirmed with CMS for 18 years — call before visiting
Phone: (662) 377-6630
Fax: (662) 377-6635
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X

Record details

NPI number1649381104
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Robert Buckley — Md · (662) 377-6630
NPI enumeratedAugust 31, 2006
Last updated in NPPESFebruary 29, 2008
Mailing address450 E President Ave, Tupelo, MS 38801-5599

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