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Organization
JACKSON HOSPITAL AND CLINIC, INC
Active
Organization
JACKSON HOSPITAL AND CLINIC, INC
Active
Other names
River Regions Facial Plastic
Organization subpart
No
Provider details
NPI number
Authorized official
TARA HERRING (REVENUE CYCLE DIRECTOR)
(334) 293-8736
Entity
Organization
Contact information
Practice address
1758 PARK PL STE 103, MONTGOMERY, AL 36106-1133
(334) 373-3611
Mailing address
1722 PINE ST STE 203, MONTGOMERY, AL 36106-1158
(334) 293-8736
(334) 293-8738
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Enumeration date
06/15/2021
Last updated
06/15/2021
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