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Organization
JACKSON HOSPITAL AND CLINIC, INC
Active
Organization
JACKSON HOSPITAL AND CLINIC, INC
Active
Other names
Jackson Family Medicine Pine Level
Organization subpart
No
Provider details
NPI number
Authorized official
KELIN PENNEY (EXECUTIVE DIRECTOR)
(334) 240-2335
Entity
Organization
Contact information
Practice address
2175 US HIGHWAY 31 N, DEATSVILLE, AL 36022-2714
(334) 568-2120
Mailing address
1722 PINE ST STE 804, MONTGOMERY, AL 36106-1108
(334) 293-8736
(334) 293-8738
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/27/2021
Last updated
03/09/2026
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