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Organization
JACKSON HOSPITAL AND CLINIC INC.
Active
Organization
JACKSON HOSPITAL AND CLINIC INC.
Active
Other names
Jackson Clinic Infectious Disease
Organization subpart
No
Provider details
NPI number
Authorized official
KELIN PENNEY (ADMINISTRATOR)
(334) 240-2335
Entity
Organization
Contact information
Practice address
1722 PINE ST STE 801, MONTGOMERY, AL 36106-1108
(334) 293-6871
(334) 293-6872
Mailing address
1722 PINE ST STE 804, MONTGOMERY, AL 36106-1108
(334) 293-8736
(334) 293-8738
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
NULL
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Enumeration date
08/10/2016
Last updated
03/09/2026
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