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Organization
JACKSON HOSPITAL AND CLINIC, INC
Active
Organization
JACKSON HOSPITAL AND CLINIC, INC
Active
Other names
Jackson Clinic Colorectal Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
TARA HERRING (REVENUE CYCLE DIRECTOR)
(334) 293-8736
Entity
Organization
Contact information
Practice address
1722 PINE ST STE 402, MONTGOMERY, AL 36106-1159
(334) 293-8736
(334) 293-8738
Mailing address
1722 PINE ST STE 203, MONTGOMERY, AL 36106-1158
(334) 293-8736
(334) 293-8738
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
—
NULL
208C00000X
Colon & Rectal Surgery Physician
Primary
—
—
Other
Enumeration date
11/02/2020
Last updated
11/02/2020
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